From Care to Where? A Care Pathways and Outcomes Report for Practitioners
Institute of CHILD CARE RESEARCH
Contents Introduction Background to the Study: Policy and practice Background to the Study: Previous research
Page
3 4 4
Statistical information: Figures from the Study 7 Characteristics of the children in the study 8 Where were the children living? 8 What influenced where the children were living? 9 Location (Board area) 9 Mother’s living arrangements 10 Parental alcohol problems 11 Age the child first entered care 11 Length of time the case was open 12 Developmental problems 13
The Parents’ Perspectives
14 Involvement in care planning: What helped? 15 Relationships with social workers 16 Helping children settle into the placement 17 Developing good child-parent relationships: What helped? 19 Contact: What helped? 21 School and friendships 24 What support was provided? 25 Parental stress 26 Children’s strengths and difficulties 28
Methodology Useful Web Sources The next stage
30 32 32
Acknowledgements The authors would like to thank, first and foremost, the parents who were interviewed during this study, for inviting us into their homes and sharing their experiences. We would also like to sincerely thank our funders, the R&D Office, for the opportunity to conduct this longitudinal study over the last seven years. Our thanks also go the Office of Social Services (DHSSPS) in Northern Ireland for providing part-funding to conduct the interviews with the adoptive parents. We are grateful to the many members of staff within Social Services, and NIGALA, for the support provided in tracking the children’s placements and searching their case files. Thank you. Thanks also to the members of the Institute’s Scientific Advisory Group and Professional Liaison Group for their sound advice and professional expertise and to Andrew Percy for reviewing various draft chapters of our initial report to funders. We are indebted to Andy Zinn from Chapin Hall Centre for Children at the University of Chicago, for helping us grasp some of the basics of event history analysis. We would also like to thank Dorota Iwaniec for her support and guidance over the years. Thanks also go to Wendy Cousins and Marina Monteith for their involvement in the early stages of data collection and to the ICCR editorial committee for helpful comments. Last, but not least, many thanks and much gratitude to Maura Dunn, Grainne McGoldrick, Lisa Monaghan, and Rosaleen Gormley for providing administrative support throughout.
From Care to Where? Practitioners’ Report | Introduction 3
Introduction This booklet is written primarily for professionals who work with children in care and their families on a daily basis, and for academics working in this area. It is the first in a series of three booklets which have been developed as part of the Northern Ireland Care Pathways and Outcomes Study, undertaken by the Institute of Child Care Research, Queen’s University Belfast.
this booklet is primarily for professionals and academics who work with children in care and their families
The aim of the study was to explore placements for all children who were under five years old and in public care in Northern Ireland on 31st March 2000. This included foster care placements, adoption, or the placement of children with their birth parents. The study also sought to determine parents’ views on how these children were managing. The Care Pathways and Outcomes Study makes an important contribution to the wider knowledge base of processes and outcomes for children in care. It is a unique study, as it examines a total population of children (at a particular point in time) across a range of care pathways. Other research in this area largely focuses on sub-samples. The term ‘foster carer’ is commonly used to define the fostering role, particularly where a placement is short-term and the child has an on-going relationship with the birth parents, however as this research is focused upon more longterm foster placements, the term ‘foster parent’ is used. The study addresses four key questions:
•
What are the care pathways for these young children in care?
•
What, if anything, predicts the type of placements provided for these children?
•
What are the views of adoptive parents, foster parents, and birth parents (of children returned home from care) regarding the child’s behavioural and emotional development, and the types of stresses involved in caring for the child?
•
What do adoptive parents, foster parents, and birth parents (of children returned home from care) think about their involvement in the care plan, the process of the child settling in, bonding and attachment, contact with birth parents or previous carers, school, friendships, and support issues?
The study provides evidence to assist policy makers and practitioners in both Northern Ireland and Great Britain in decision-making regarding the longterm placement of young children in care, and the development of
evidence-based practice. We hope it can contribute to ensuring that every child in care in Northern Ireland achieves the placement that can best meet their needs, and which allows them to achieve their full potential. You can find out more about the way the study was carried out at the back of the booklet. The findings will also be presented in a series of journal articles. This report, together with a report for parents, and for children and young people, is available free from http://www.qub.ac.uk/cpo
4 Introduction | From Care to Where? Practitioners’ Report
Background to the Study: Policy and practice Placement alternatives While most children grow up in a safe and secure family environment, a minority face violence, abuse and neglect in their own homes. When children suffer, or are likely to suffer, significant harm, the State has a duty to intervene on their behalf. When efforts to secure children’s safety and wellbeing within their own families fail, the law makes provision for the responsible Health and Social Care Trust to share parental responsibility with the parent through a Care Order (Children (NI) Order, 1995). In these cases, children ‘in care’ are placed in substitute care placements, including:
•
foster care with relative carers or friends;
•
foster care with non-relative carers; and
•
residential care.
In some circumstances, a child can be accommodated by a Trust on a voluntary basis, perhaps as a result of temporary problems within the family (e.g. maternal depression). In these circumstances, parents retain full parental responsibility and can resume care of their child at any time. Birth parents When reunification with their families of origin is thought possible, children subject to Care Orders may be ‘placed’ with their birth parents, pending progress and the revocation of a Care Order. Adoption Adoption transfers parental responsibility firstly to the Trust (‘Freeing Order’) and subsequently to the adopters. Adoption is regarded as the best placement option for children who cannot live with their birth parents nor be placed with relatives (Cole, 1985). Northern Ireland was slow
to embrace the notion of adoption for children in public care (Kelly, 1999; Kelly and McSherry, 2002). However the way adoption is viewed, used, and managed in Northern Ireland has changed in recent years and there is now an increased focus upon adoption by all Boards and Trusts, although not to the same degree. This is linked to the recent overhaul of adoption law in the UK. Key documents include: The Prime Minister’s Review of Adoption (Performance and Innovation Unit, 2000), the ensuing White Paper, Adoption: A New Approach (2000), and the Adoption and Children Act (2002). Adopting Best Care, the report of the Social Services Inspectorate’s inspection of adoption services in Northern Ireland (DHSSPS, 2002), made a wide range of recommendations directed at the Department, Boards, and Trusts. These included a recommendation to introduce new legislation more closely aligned to the principles of the Children (NI) Order (1995), and suited to the needs of a modern adoption service. The report also highlighted the need for a regional adoption strategy that would establish better support structures and services for children, families and all other persons affected by adoption processes. These developments are reflected in the recent departmental consultation report, Adopting the Future (DHSSPS, 2006). The range of children for whom adoption is now considered as a placement option has broadened to include older children and those who have been in care for extended periods (DHSSPS, 2002; Kelly and McSherry, 2002). Foster care Children may remain in either relative or non-relative foster care on a long-term basis. Some foster parents may choose to apply for a Residence Order, which effectively takes the child out of the public care system. Foster care remains the placement of choice for many children who cannot remain with their birth parents and for whom adoption is not deemed appropriate.
Over the past two years, the Department has raised foster care allowances to nationally agreed minimum rates and has introduced new funding to give foster carers direct access to educational support including computers and tutoring for fostered children. Funding is also now in place to enable fostered children to continue living with their foster carers until they are aged 21. The four Health Boards have established a regional fostering team which co-ordinates efforts to train foster carers and have also put in place a 24/7 help-line for foster carers. Work is also underway to provide foster carers with more autonomy in decision-making about fostered children on a day-to-day basis. Furthermore, the ‘Care Matters in Northern Ireland’ consultation paper (2007) outlines government strategy for the future of care provision in Northern Ireland. Proposals aim to increase preventative services; improve the range, quality and stability of placements for children in care; strengthen the ‘corporate parenting’ role of HSC Trusts; enhance educational opportunities and experiences outside school; and support young people’s transition into adulthood.
Background to the Study: Previous research Outcomes for children in public care Children who have been in care are: 10 times more likely to be excluded from school; 12 times more likely to leave school with no qualifications; 4 times more likely to be unemployed; 60 times more likely to join the ranks of the homeless; 50 times more likely to be sent to prison; and their own children are 66 times more likely to need public care than the children of those who have not been in public care themselves (UK Joint Working Party on Foster Care, 1999; DHSSPS, 2006). Mooney, Fitzpatrick, & Hewitt (2006) indicated that in Northern Ireland, 96 (10%) of the 986 children aged over nine years old in public care were cautioned
From Care to Where? Practitioners’ Report | Introduction 5
or convicted in 2002/03, compared to 1% of all children in Northern Ireland; and 9% of school age children in care were suspended from school in 2002/03, compared with 1.7% of the general school population in Northern Ireland. A difficulty is that these figures typically compare children who have been in care with the average for the whole population, rather than children from the same backgrounds who have not been in care. There is also a tendency for the ‘problem’ under review to be associated with the child being in care, rather than also taking into consideration the factors that may have resulted in the child being admitted to care in the first instance. Numerous Government initiatives have been launched in Great Britain to help ensure the best life-outcomes for children in care (Quality Protects, DOH, 1999; Choice Protects, DFES, 2002; and Every Child Matters, 2003). However research continues to suggest that children in long-term foster care are more likely to move placement than those in adoptive placements (Ward, Munro, Deardon, and Nicholson, 2003; Wilson, Sinclair, Taylor, Pithouse, et al., 2004; Sellick, Thoburn, and Philpot, 2004; Sinclair, 2005). For example, Sinclair (2005, p.157) noted that in most instances ‘long-term foster care does not offer a secure family for life’. Placement stability There has been much debate as to why it is proving difficult to improve placement stability for children in long-term foster care. One argument is that current foster care structures do not encourage the level of commitment of foster carer to child necessary to see them both through the inevitable crises that they face. An alternative argument is that the concentration on adoption as the ‘holy grail’ of placements has resulted in a diminution of the status of, and investment in, foster care. Rushton (2004, p.91) argued that ‘advancing adoption as the preferred placement choice is driven not only by child-welfare imperatives, but also by the need to reduce State
expenditure on the ‘in care’ population. Furthermore, to favour adoption ... may also turn alternatives like long-term foster care and residential care into second-class options, although good quality placements of this kind may be the first choice for some children’. Similarly, Sinclair (2005, p.17) noted ‘a lack of attention to longterm foster care as opposed to the more highly valued adoption’. Adoption and fostering Research that compares adoption and long-term fostering consistently reports adoption as delivering better outcomes. Triseliotis (2002, p.31) noted that ‘compared with long-term foster care, adoption still provides higher levels of emotional security, a stronger sense of belonging, and a more enduring base in life for those who cannot live with their birth parents’. Sinclair, Baker, Wilson, and Gibbs (2005, p.103) reported that adopted children were doing better on most outcome variables, although not dramatically so. They attributed this, in part, to the ‘family’ feeling that adoptive placements generate in children. They noted that the ‘difference between adoption and long-term fostering is partly symbolic. Foster carers are not parents, while adoptive carers are’. Yet, research by Schofield (2002, p.271) highlights that some children who spend their lives with foster parents do consider them to be ‘their real parents’, in much the same way that adopted children view their adoptive parents. Returning home Although there has been a growth in interest and research over the last decade on the lives of children who remain in foster care or are adopted, the experience of those children who return home after a period in care has received relatively little attention (Bullock, Gooch and Little, 1998). Research that has managed to incorporate the experiences of these children (Aldgate and Bradley, 1999; Cleaver, 2000; Selwyn et al., 2003; Skuse and Ward, 2003; Sinclair et al., 2005) has highlighted both the difficulty
of attempting to recruit hard-to-reach children, and the importance of trying to do so. Skuse & Ward (2003) interviewed 49 children (39% of their sample) who had returned home at some point during the tracking period of their study, which was examining children’s own perspectives of care and accommodation. The study revealed a worrying picture of the lives of rehabilitated children, which was typified by a lack of formal support. Older children tended not to remain at home for long, with multiple transitions between different relatives being commonplace. The study raised questions about the emphasis that is placed on children returning home; the extent to which these placements are supported when the child does return home; and the appropriateness of defining return-home placements as permanent. Decision-making Many studies look at what influences where the child is placed, be it either foster care, adoption, or a return to birth parents, and/or the experiences of the children and their families. However, there are very few longitudinal studies that have examined the range of placements, that is, relative and non-relative foster care, adoption and return to birth parents, and compared outcomes (Sinclair et al., 2005; Ward, Munro and Deardon, 2006). Northern Ireland Northern Ireland provides the ideal environment for such research. Its size means it is possible to investigate a total population of children within a single study, rather than sub-groups. The opportunity to conduct such a study was provided by the Research and Development Office in 1999. Their funding allowed the Institute of Child Care Research to design and conduct a large-scale longitudinal study on children’s care pathways and outcomes, with a particular focus on the type of care pathway followed and how the carers or parents felt the child was doing in that placement. The aim of the study was to provide information that would assist in
6 Introduction | From Care to Where? Practitioners’ Report
the decision-making process regarding the long-term placement of young children in care, and help towards ensuring that every child achieves the best possible long-term placement. The following report describes the findings of the first two phases of the study – Care Pathways and Outcomes: Multiple Placements (2000–2003) and Care Pathways and Outcomes: The Carers’ Perspective (2003–2006). References Adoption and Children Act 2002. London: Stationery Office. (available from: http://www.opsi.gov.uk/acts/ acts2002/ukpga_20020038_en_1) Aldgate, J. and Bradley, M. (1999) Supporting Families through Short-term Fostering. London: The Stationery Office. Children (NI) Order 1995. Belfast: Stationary Office. (available from: http://www.opsi.gov.uk/si/si1995/ uksi_19950755_en_1) Cleaver, H. (2000) Fostering family contact: A study of children, parents and foster carers. London: The Stationary Office. Cole, E. S. (1985) Director’s report, permanency report. New York: Child Welfare League of America. Department of Health (2000) Adoption: A New Approach. A White Paper. London: Department of Health. DHSSPS (2002) Adopting Best Care: Inspection of Statutory Adoption Services in Northern Ireland. Belfast: Department of Health, Social Services, and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí. (available from: http://www. dhsspsni.gov.uk/adoptpart1.pdf) DHSSPS (2006) Adopting the Future. Belfast: Department of Health, Social Services and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí. (available from: http://www.dhsspsni.gov.uk/ adopting_the_future_16-6-06pdf. pdf )
DHSSPS (2007) Care Matters in Northern Ireland: A bridge to a better future. A consultation paper. Belfast: Department of Health, Social Services and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí. (available from: http://www. dhsspsni.gov.uk/care-matters-ni-3. pdf) Kelly, G. (1999) Foster parents and long-term placements: Key findings from a Northern Ireland study. Children and Society, 9, 19-29. Kelly, G. and McSherry, D. (2002) Adoption from care in Northern Ireland: Problems in the process. Child and Family Social Work, 7, 297-309. Mooney, E., Fitzpatrick, M. and Hewitt, R. (2006) Outcome Indicators for Looked After Children. Year Ending 30 September 2003 Northern Ireland. Statistical Bulletin. Belfast: Department of Health, Social Services and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí. (available from: http://www.dhsspsni. gov.uk/cib-oc2-2003.pdf) Performance and Innovation Unit (2000) The Prime Minister’s Review of Adoption. London: The Cabinet Office. Rushton, A. (2004) A scoping and scanning review of research on the adoption of children placed from public care. Clinical Child Psychology and Psychiatry, 9(1), 89-106. Schofield, G. (2002) The significance of a secure base: a psychological model of long-term foster care. Child and Family Social Work, 7, 259-272. Sellick, C., Thoburn, J. and Philpot, T. (2004) What Works in Adoption and Foster Care? London: Barnardos/BAAF. Selwyn, J., Sturgess, W., Quinton, D. and Baxter, C. (2003) Costs and Outcomes of Non-infant Adoptions: Report to the Department for Education and Skills. London: DfES.
Skuse, T. and Ward, H. (2003) Listening to Children’s Views of Care and Accommodation. Report to the Department of Health. Loughborough: Centre for Child and Family Research, University of Loughborough. Sinclair I. (2005) Fostering Now: Messages from Research. London: Jessica Kingsley Publishers. Sinclair, I., Baker, C., Wilson, K. and Gibbs, I. (2005) Foster children: Where they go and how they get on. London: Jessica Kingsley. Triseliotis, J. (2002) Long-term foster care or adoption? The evidence examined. Child and Family Social Work, 7, 23-33. UK Joint Working Party on Foster Care (1999) UK National Standards for Foster Care. London: National Foster Care Association. Ward, H., Munro, E., Dearden, C. and Nicholson, D. (2003) Outcomes for Looked After Children: Life Pathways and Decision-Making for very Young Children in Care Or Accommodation. Loughborough: CCFR. Ward, H., Munro, E.H. and Deardon, C. (2006) Babies and Young Children in Care: Life Pathways, Decision-making, and Practice. London: Jessica Kingsley. Wilson, K., Sinclair, I., Taylor, C., Pithouse, A. and Sellick, C. (2004) Fostering success. an exploration of the research literature in foster care. London: Social Care Institute for Excellence (SCIE).
Statistical Information: Figures from the Study
8 Statistical Information | From Care to Where? Practitioners’ Report
Characteristics of the children in the study There were 374 children who were under 5 years old and in care in Northern Ireland on the 31st of March 2000. These children came into care for a number of reasons. Table 1 Child’s background and characteristics
Percentage
Adoption has become a major care pathway for young children who are unable to return home from care in Northern Ireland. This is an important finding, because 5 years before the study started, there were very few children being adopted from care in Northern Ireland (Kelly and Coulter, 1995). However, despite the development of adoption, a large number of children seem destined to spend their childhoods in foster care.
Family history of alcohol abuse
76%
Family history of mental illness
63%
Family history of domestic violence
76%
Behavioural problems
23%
Where the children were living in 2004
Developmental delay
18%
Adoptions
153
In care due to neglect
52%
Birth parents
97
In care due to abuse
40%
Non-relative foster care
83
From single parent households
54%
Relative foster care
22
Residence Order
14
Where were the children living? The range of placements presented in chart 1 and table 2 represent 5 key care pathways for this group of children, i.e. towards adoption, placement with birth parents, non-relative foster care, relative foster care, and Residence Order. The percentage of children staying in nonrelative foster care fell between 2000 and 2004 (from 61 to 22%). This was mostly explained by the rise in the number of children being adopted (0 to 38%). There was also an increase in the percentage of children living with their birth parents (14 to 27%), with this increase slowing with time, i.e. there was an 8% rise between 2000 and 2002, but only a 5% rise between 2002 and 2004.
Implications The number (n=140) and the proportion (38%) of the children who were adopted by 2004 are evidence of the growth of a ‘permanence movement’ in Northern Table 2 Number of children
the Freeing Order provisions in the Adoption (NI) Order 1987 (Kelly and McSherry, 2002). References Kelly, G. and Coulter, J. (1995) The Children (NI) Order, 1995: A new era for fostering and adoption services. Fostering and Adoption, 21(3), 28-34. Kelly, G. and McSherry, D. (2002) Adoption from care in Northern Ireland: Problems in the process. Child and Family Social Work, 7, 297-309. Useful web sources Information on adoption in the UK: http://www.adoption.org.uk/ information/default.html British Association for Adoption and Fostering (BAAF): Information and advice on adoption and fostering in Northern Ireland: http://www.baaf.org.uk/local/ ni/index.shtml Statistics on child protection and Looked After Children in Northern Ireland: http://www.dhsspsni.gov.uk/stats-cibchildren_order_bulletin
Ireland which has drawn inspiration from the developments in Great Britain, and has begun to make greater use of
Chart 1 Placement patterns for 2000, 2002, and 2004 (%)
Adopted Birth parents Non-relative foster care Relative foster care Residence Order
2000
Prospective adoption
2002
2004
Assessment unit
Practitioners’ Report | Statistical Information 9
What influenced where the children were living?
Chart 2 Percentage of children in each pathway by Health and Social Service Board
A range of factors influenced the 5 key care pathways the children had taken by 2004 (towards adoption, non-relative foster care, relative foster care, return to birth parents, and Residence Order). These factors were: location; mother’s living arrangements; parental alcohol problems; age the child first entered care; length of time the case was open; and developmental problems.
Adopted Birth parents Non-relative foster care
Location (Board area) Location (Board area) seemed to influence whether children were being adopted, remaining in foster care, or returning home to their birth parents. Higher percentages of children followed the adoption pathway in the Northern (59%) and Southern (69%) Boards, compared to the Eastern Board (33%) and the Western Board (19%). Higher percentages of children followed the non-relative (46%) and relative foster care (14%) pathways in the Western Board; and a higher percentage of children followed the birth parents (34%) pathway in the Eastern Board. In both the Northern and Southern Boards, 12% of the children in care were at home with their parents in 2000. These figures were 18% in the Eastern Board, and 9% in the Western Board area. Children from the Eastern Board, who were in foster care in 2000, were 6½ times more likely to be returned to birth parents by 2002 than those from the Northern Board. It was also found that children from the Northern Board were 2½ times more likely to be adopted by 2002 than those from the Western Board. Such variation in decision-making in child welfare has been found in many studies
Relative foster care Northern
Residence Order Southern
Eastern
and jurisdictions (Packman, 1966 and 1986; Lowe and Murch, 2002). Even where there is general agreement on what the long-term plan should be for young children who cannot return, different authorities generate very different patterns. For example, there is evidence that the Northern Board developed specific organisational structures, including specialist staff, to promote the use of adoption for children in care during the period of this study (Kelly et al., 2007). Implications Given that statistical comparisons across multiple variables showed that the groups of children within each of the Trusts are very similar, these variations may lie in the decision-making, and particular traditions of the Boards and Trusts (McSherry and Larkin, 2006). This issue has been highlighted by Adopting Best Care (DHSSPS, 2002), whilst the DHSSPS are proposing the regionalisation of adoption services (DHSSPS, 2006). The variation in the proportion of children returned home also needs further and careful consideration in view of the evidence of
Western
the troubled nature of the return home placements that this study has identified (see part two which deals with the parent and carer interviews). A key question is: If the needs of the child are central to deciding on a longterm placement, why are major variations in professional decision-making being found across Northern Ireland? The recent Reform of Public Administration (RPA), creating five Health and Social Care Trusts where there were previously 11, the development of Regional Policy and Procedures in relation to adoption, and the Government’s plan to regionalise elements of the adoption service, may help foster greater consistency. However, consistency will not be improved if the reasons for inconsistency stem from more deeply held values/opinions on the appropriateness of different placement paths for children and families.
10 Statistical Information | From Care to Where? Practitioners’ Report
References DHSSPS (2002) Adopting Best Care: Inspection of Statutory Adoption Services in Northern Ireland. Belfast: Department of Health, Social Services, and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí. (available from: http://www.dhsspsni. gov.uk/adoptpart1.pdf) DHSSPS (2006) Adopting the Future. Belfast: Department of Health, Social Services and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí. (available from: http://www.dhsspsni.gov.uk/ adopting_the_future_16-6-06pdf.pdf )
Mother’s living arrangements The percentage of children whose mother was living alone on 31st March 2000 was high (54%) compared with the average population for Northern Ireland of around 15% (Percy, Higgins, and McCrystal, 2001). This high level of lone parenting mirrors other research in this area (Kelly and McSherry, 2002; Selwyn et al., 2003). Children whose mother was living alone when the study started were 2½ times more likely to be adopted by 2002 than those whose parents were living together. This may suggest that Social Services are more likely to deem lone parents to be less able to provide long-term care for their children. Implications The need for a family support strategy to be developed in conjunction with the Boards and Trusts was outlined in Priorities for Action 2004/2005 (DHSSPS, 2004a), and the 20-year regional strategy (A Healthier Future) focused on the importance of family-support services (DHSSPS, 2004b). The findings presented here should encourage Heath and Social Care Trusts, and other relevant
Kelly, G., Haslett, P., O’Hare, J. and McDowell, K. (2007). Permanence planning in Northern Ireland: A developmental project. Adoption and Fostering, 31(3), 18-27.
Packman, J. (1986) Who needs care? London: Basil Blackwell. Packman, J. (1968) Child care: Needs and numbers. London: Allen and Unwin.
Lowe, N. and Murch, M. (2002). The plan for the child: Adoption or long-term fostering. London: BAAF. McSherry, D. and Larkin, E. (2006) Exploring Regional Trends in Pathways to Permanency. In: D. Iwaniec (Ed.), The Child’s Journey Through Care: Placement Stability, Care Planning, and Achieving Permanency (pp.113-130). Chichester: Wiley.
care agencies, to review the nature and quality of supports that are currently in place for lone parents, particularly in terms of preventing children entering the care system. References DHSSPS (2004a) Priorities for action 2004/2005. Planning priorities and actions for the Health and Personal Social Services. Belfast: Department of Health, Social Services and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí. DHSSPS (2004b) A healthier future: a twenty year vision for health and wellbeing in Northern Ireland 20052025. Belfast: Department of Health, Social Services and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí. Percy, A., Higgins, K. and McCrystal, P. (2001) The Youth Development Study: Research Update for Schools. Issue 1, Autumn 2001. Belfast: Institute of Child Care Research, Queen’s University.
the percentage of children whose mother was living alone was high compared to the rest of the Northern Irish population
Practitioners’ Report | Statistical Information 11
Parental alcohol problems It was found that children whose parents had a history of alcohol problems were 3 times less likely to be returned to their birth parents by 2002 than those who did not. Only 8% of children who were returned to birth parents by 2004 came from a family with a history of alcohol problems. This suggests that where there are alcohol problems in the family, these can remain intractable, and prevent the child returning home to the birth parents. These findings reflect
Age the child first entered care
Kelly and McSherry’s (2002) findings that mother’s alcohol abuse was a problem in 42% of the families whose children were Freed for adoption, with father’s alcohol abuse being a problem in 28%. Implications In 76% of these cases, there was a family history of alcohol abuse. Failure to resolve parental alcohol problems decreases the likelihood of children returning home from care. Consequently, the findings should encourage agencies to review the support services that are available to parents who are struggling with alcohol related
References Kelly, G. and McSherry, D. (2002) Adoption from care in Northern Ireland: Problems in the process. Child and Family Social Work, 7, 297-309.
Chart 3 Percentage of children in each pathway by age first entered care
Children who first entered care under one year old were 2½ times more likely to be adopted by 2002 than those who first entered care aged between 1-2 years old. Most of the children (70%) who were adopted by 2004 were less than one year old when they first entered care. The older children were when they first entered care, the more likely they were to be fostered. Chart 3 shows that as the age of the child increased, the percentage of children in the adoption and Residence Order pathways decreased, with only 8% and 7% respectively first entering care at between three and four years old. In contrast, the birth parent and relative foster care pathways showed a less dramatic decline, and the nonrelative foster pathway had the highest percentage (45%) of children who first entered care aged between one and two years old.
problems, particularly those whose children have been removed from their care as a result of these difficulties.
3-4 yrs
Birth parents
Adoption
Rel. foster care
Although younger children are more likely to be adopted, chart 4 shows that as many as 29% of the 115 children who were 1-2 years old when first entered care, and 25% of the 49 children who were 3-4 years old, had been adopted by 2004.
1-2 yrs
< 1 yrs
Non-relative foster care
Residence Order
Total
Implications In terms of the system in England and Wales, Sinclair et al. (2005, p.93) found that adoption was essentially restricted to children under one year old, and that ‘adoption and birth family were essentially
12 Statistical Information | From Care to Where? Practitioners’ Report
the only options for this age group’. However, although adoption rates are very high for children who enter care under one year old, our findings present quite a different picture, with sizeable percentages of children who enter care between the ages of one and four being adopted. Furthermore, 20% of children under the age of one when they first entered care were still in foster care after
four years. Clearly, adoption was not the only option for this age group in Northern Ireland. This appears to reflect the variation in long-term placement practices across Northern Ireland. For example, in the Southern Board area, no children who entered care before the age of one remained in foster care, whereas this figure is as high as 52% in the Western Board area.
References Sinclair, I., Wilson, K. and Gibbs, I. (2005) Foster children: Where they go and how they get on. London: Jessica Kingsley Publishers.
Chart 4 Percentage of children in each age group when first entered care by pathway
1-2 Years
<1 Year Old 5.2% 14.1%
3-4 Years 2%
3.5% 21.4% 31.3%
30.4%
4.7%
6.1%
54.6% 192 Children Birth
Adopted
Length of time the case was open Children whose case was open less than a year in 2000 were 4 times more likely to be returned to birth parents by 2002 than those whose case had been open between 1-2 years, and 25 times more likely than those whose case had been open between 3-4 years.
The longer children stay in care, the less likely it is that they will return to birth parents (Kelly 1989; Biehal, 2006).
10%
28.7%
31%
32%
25%
115 Children Relative Foster Children
Non-Relative Foster Children
Implications Our findings support other research (Kelly, 1989; Biehal, 2006) which suggests that children are more likely to return to birth parents in the early stages after being taken into care, and that the longer they stay in care, the less likely it is that they will return to birth parents. This has major implications for Health and Social Care Trusts in terms of ensuring that the necessary resources are made available to foster and adoptive parents who are tasked with providing long-term care for those children who do not return home.
49 Children Residence Order
References Kelly, G. (1989) Patterns of care: The first twelve months. Belfast: Department of Health and Social Services. Biehal, N. (2006) Reuniting looked after children with their families. London: National Children’s Bureau.
Developmental problems Eighteen percent of all the children in the study presented developmental delay prior to 2000.
Children who showed evidence of developmental delay prior to March 2000 were twice as likely to return to birth parents by 2002 than those who did not. Implications Whatever the reason for the increased likelihood of children with developmental delay returning to their birth parents, these findings suggest that Social Services need to ensure that adequate supports are provided to birth parents when children return home from care, particularly where the child may have some form of disability. Adoptive parents and foster parents have advocacy services available to them, such as Adoption UK, the Fostering Network, and the British Association for Adoption and Fostering (BAAF). There is a need for the development of an advocacy service for parents whose children have returned home from care.
Practitionersâ&#x20AC;&#x2122; Reportâ&#x20AC;&#x192; |â&#x20AC;&#x192; Statistical Information 13
The Parentsâ&#x20AC;&#x2122; Perspectives We spoke to the foster parents of 55 children, the adoptive parents of 51 children, and the birth parents of nine children who had returned home.
From Care to Where? Practitioners’ Report | The Parents Perspectives 15
Involvement in care planning: What helped? While children are in care, their care plan arrangements become crucial issues for both foster and birth parents, as well as an important part of their relationship with Social Services. What the foster parents said: Most foster parents felt involved in the decisions taken around the care plan. Some of them were still awaiting final decisions, and were hoping that the child’s placement would eventually be formalised as permanent. However, a few said that they did not feel sufficiently involved, or had little knowledge about how decisions on the care plans were made, and felt like they were ‘at the bottom end of the brush’ in this process.
“
I suppose that is one of the good things about social services: they are there to speak for you if you need [them] (Foster parent)
”
“
I think Social Services try to push in things that we find maybe aren’t important ... we consider ourselves as the long term carers ... we are the ones that know them best and sometimes they come in and you feel as if they are disrupting things rather than trying to make them better. (Foster parent)
”
What the birth parents said: Some birth parents did not feel involved in the decisions taken around the care plan, felt unwelcome, powerless and threatened at Looked After Children (LAC) meetings, and found court processes stressful and lengthy. On the other hand, a few birth parents felt confident in expressing their views, believed that they were listened to, and even felt that Social Services had been ‘very supportive’ and ‘very accommodating’. That was particularly the case for one mother who had LAC review meetings held in her own home.
“
No matter what I said at them reviews, they never seemed to listen. ... you were there to voice your concerns but they only wanted you there so that they could dictate to you and tell you what to do. (Birth parent)
“
”
then a couple of times, they [LAC meetings] actually came out to the house because it was easier for, handier for me ... They [Social Services] were very, very accommodating, they were very good . . .
(Birth parent)
care plan arrangements were important issues for parents and carers
”
16 The Parents Perspectives | From Care to Where? Practitioners’ Report
Relationships with social workers For adoptive parents, birth parents, and foster parents, experiences of the care system often appeared to depend on the relationship they had with social workers. While there were positive examples of good working relationships, there were also references to more negative experiences.
“
Our social worker used to come and baby-sit for us ... that was very practical and great, because in the early stages you don’t know who you can trust to look after your adopted child.
”
(Adoptive parent)
“ “
Foster parents’ descriptions of social workers went from ‘a disaster’ and ‘too nosey’, to ‘brilliant and great’, ‘helpful’, ‘fantastic’, ‘second to none’ and ‘very supportive’. Similarly, while some birth parents had very bad relationships with some social workers, some also had extremely positive relationships, above all when they felt the social worker did not ‘judge them’ and treated them ‘with respect’.
Foster and birth parents reported constant changes of social workers. Birth parents said that frequent changes of social workers caused them considerable disruption and stress. This is concerning given that most of these parents were already living in already volatile circumstances. Foster parents felt that
a change in social worker could unduly complicate arrangements that were already in place, and could negatively impact upon the general outcomes of the foster placement.
“
It’s stupid because you get another one and they don’t know what they’re doing, when there’s one that knows ... I hate them changing all the time. (Birth parent)
“
”
Then one particular social worker came one day and said ‘look, you know, I wouldn’t do that’ ... and that’s the way it is now. (Foster parent)
”
They’re there definitely if you need [them] ... (Foster parent)
”
The social workers ... are trying to tell you something out of the book that is not practical, there was a couple of them and I said look I prefer you not to come back again ... sometimes they are hard to listen to. (Foster parent)
”
“
The social worker always wanted the Court Order and she always got it ... It was her actually got the police and it was actually her that came out to the door with the police and took the kids out of the house. (Birth parent).
“
”
The social worker’s the one person in my life that never, ever judged me, she always seen me as individual, as a person, not just as a mum. (Birth parent)
”
constant changes of social workers often caused disruption and stress for parents
From Care to Where? Practitioners’ Report | The Parents Perspectives 17
Helping children settle into the placement The interruption of a relationship with a primary attachment figure can be a difficult experience for a child. Children in care are often faced with abrupt changes: new routines, having to learn to trust a new family, and to adapt to a new way of living. It was not surprising, therefore, that settling in was rarely described as an easy process. Most adoptive parents and foster parents believed that their children had eventually settled in well in their placements. Similarly, birth parents said that it took time for the family to settle down when a child returned home from a period in care. However, most reported difficulties that both they and the children had experienced, particularly early on. Interviews also suggested that a successful settling in was very much helped by the children’s ability to say where they belonged, and where their home was.
What the foster parents said:
“
She banged her head against the walls, she slapped herself round the face, she bit, she couldn’t eat off a spoon, anything at all .... (Foster parent)
”
Despite some difficulties, most of the foster parents had successfully worked through this initial period. ‘Making a new life’, ‘coming on nicely’, ‘making progress’, ‘starting to smile’, and ‘responds to kindness’ are examples of expressions that foster parents used to express how the children had settled in.
“
The biggest issue was where she was going to be and we could never honestly say to her: you will stay here ... So, the fact that you could come to her and say to her you will stay here; she has settled so much better, she has fewer problems with access [to her birth family] as she knows she is going for a visit and not staying. (Foster parent)
”
“
[Our foster child] is ‘part and parcel’ of the household and that’s it, and that way he’ll remain until either he or powers beyond our control decide otherwise. (Foster parent)
”
children in care are often faced with abrupt changes, having to learn to trust a new family, and to adapt to a new way of living
18 The Parents Perspectives | From Care to Where? Practitioners’ Report
What the birth parents said: Although most birth parents interviewed also said that their children had settled back home very well, some difficulties were described. For instance, a mother explained how her child was fostered by his grandmother, though the two women did not have a good relationship at the time. According to the birth mother, when her son returned home, it took him ‘a long time to accept that I was the boss’, and she felt that it took her mother some time to ‘back off’.
child’s particular characteristics, issues and needs, including a range of often serious conditions (e.g. Foetal Alcohol Syndrome, ADHD, Chronic Asthma, Failure to Thrive, Anxiety).
She didn’t understand whether she was going to be here full-time or whether somebody was going to come and take her away again. So, she was worried about this until we actually sat down and talked to her and said, ‘No, you’re here for good now.’ (Birth parent)
”
“
”
What the adoptive parents said: Adoptive parents described the challenges that they faced at the start of the placement, such as adapting to the demands of parenthood; and learning to understand and manage their
“
I found ... the first few months very difficult ... particularly when he was first placed, he was insecure and unsure of himself, and basically didn’t like to let you out of his sight ... I found adapting to that very difficult. (Adoptive parent)
Adoptive parents also identified a range of factors that helped them ease the settling-in process, which included:
• • •
gradually relaxing;
•
creating and building on ‘a shared history’; and
•
establishing a family routine.
feeling accepted as ‘mum’ or ‘dad’;
“
she’d always been brought up to know that a ‘forever mummy and daddy’ were being looked for, for her, that was always in her mind, and ... in that week that we were getting to know her she did start to call us ‘mum and dad’ ... so that sort of made it easier because you sort of felt you were accepted. (Adoptive parent)
“
”
Now he has a life with us that he can talk about and share, and he’s got all his wee friends at school ... (Adoptive parent)
”
having a sense of working towards a new life together;
almost all parents and carers believed that the children had eventually settled in well
From Care to Where? Practitioners’ Report | The Parents Perspectives 19
Developing good childparent relationships: What helped? Bonding
Despite some initial difficulties, adoptive parents, foster parents, and birth parents all said that they had eventually felt an emotional connection (bonded) with their children. Of the factors that they thought had helped, the child’s age was identified as particularly important for adoptive and foster parents. The younger the child was, the easier the process of bonding. What the adoptive parents said: Some adoptive parents described an ‘instant’ or very quick sense of bonding over time from first meeting the child. Others described the bonding process as something that was often difficult at first and required sustained input. All felt that they had developed stronger bonds with their children over the course of the placement. A number of key indicators of bonding emerged from their interviews, such as:
• •
loving the child;
•
feeling as though the child had become part of their family and central to their life;
•
developing a reciprocal and trusting relationship with the child;
• •
feeling protective of the child;
•
feeling as though such commitment was rewarded.
identifying the child as their ‘own’ child and not somebody else’s;
being committed to identifying and addressing the child’s needs and the various demands placed on them by the child; and
“
I don’t know, it’s like an inner warmth, you get so much satisfaction out of seeing what it’s like watering a flower from wee seeds – the more you water and care and nurture that the more it’s going to blossom... and I feel it’s like that, the more I water and more input we put in as a family, and it’s so rewarding. Simple wee things are so rewarding and so warm. (Adoptive parent)
“
”
Because we got him from a baby he was just ours from the beginning ... he moulded into our way of life. (Adoptive parent)
The adoptive parents identified a number of factors as influential in the bonding process, including:
• •
the child’s age at placement;
•
the extent to which the reality of the adoption matched the parents’ prior expectations;
•
well wishes, support and positive feedback from friends and family;
•
qualities of the child (such as being ‘loving’, ‘trusting’, ‘positive, ‘cheerful’ and resilient); and
•
sharing common interests/spending time with the child.
the security afforded to the parent by a legal adoption;
”
the younger the child, the easier the process of bonding
20 The Parents Perspectives | From Care to Where? Practitioners’ Report
What the birth parents said: Birth parents thought that their children had bonded again with them ‘straight away’ when they returned from foster care, and had re-established good relationships with siblings, although in some instances the relationship had needed to be rebuilt. For instance, one birth parent described a process of having to ‘earn their children’s trust all over again’. The majority of birth parents felt the bond with their children had grown stronger and felt that the children respected them more since they had returned home. What the foster parents said: Whilst foster parents would be expected to provide affection to children and to act as positive attachment figures to assist healthy development, many found this quite difficult and felt that Social Services did not always provide the necessary support when they were having difficulties forming a relationship with the child. Most foster parents reported that the foster children had bonded well with other family members, and said that they ‘got on well’, even ‘extremely well’ or ‘terrific’.
Foster parents raised a number of factors that they felt were important to the bonding process:
•
the difficulties that the children came with;
•
the immediate ‘liking’ they and their families took to them; and
•
the relationships developed between the children and other relatives and children living in the home, whether they were also adopted children, were being fostered, or were the foster parents’ birth children.
Attachment In terms of the development of an attachment relationship between the child and themselves, i.e. the extent to which the child had developed an emotional connection to them, adoptive parents identified some indicators of attachment, such as:
•
the child referring to them as ‘mum’ or ‘dad’;
•
their knowledge of their child’s feelings and behaviours; and
•
knowing that their child felt secure in a safe home with committed parents.
“
I suppose the fact that she talks less about the foster parents now ... they’re still her memories ... but you can see how it has transferred over ... and the dependence ... she has been prepared to transfer it over. And it’s Mum and Dad, and it has been for a long, long time. (Adoptive
parent)
”
The adoptive parents identified a number of factors they felt had assisted the attachment process for the child. These included:
• •
open, honest communication; preparation for the transition from foster care to the adoptive placement, including life book work;
“
He came so young, I mean he’s never known any other parents only us ... He came at five months so he’s grown up here, so I mean this is his family. It’s different if you take an older child. (Foster parent)
“
”
[our children] would see [our foster child] as their brother, he sees our older daughter as his big sister, they all get on very well ... [our children] treat him as a small brother, there’s no conflict. (Foster parent)
”
Child attachment developed when they felt secure in a safe home with committed parents
From Care to Where? Practitioners’ Report | The Parents Perspectives 21
•
coming to terms with having multiple parents;
•
feeling secure about their ‘forever home’;
•
discontinuation of social worker involvement; and
•
learning healthy attachment behaviour through the example of other children.
The good relationship that foster parents described between the children they were
Contact: What helped? The issue of maintaining contact between children who are looked after away from home and their birth families is contentious and has generated some debate within research and professional circles. While some argue that it is crucial to maintain contact with the birth family (on the basis of the strength of the research evidence regarding its positive effects), others contend that contact might destabilise the new relationship with the foster or adoptive family (Browne and Moloney, 2002). In fact, there is a dearth of empirical research on either the beneficial or adverse effects of contact (Quinton et al., 1997; Biehal, 2006). What the foster parents said: Often, the frequency of the contact visits was determined by court decisions, and both foster parents and social workers alike felt obliged to follow these decisions, regardless of whether or not they thought the child benefited. In cases where direct contact between foster parent and birth family was not possible, Social Services transported children to and from contact visits. In other cases, foster parents were expected to transport children to and from birth parents’ homes for contact visits. Some foster parents said that contact visits disrupted the children’s routines and explained how children were sick and aggressive after they returned from the visits.
fostering may reflect the relative stability of these placements*. A majority had long-term care plans in place, one foster family had applied to adopt the child they were caring for, and two other foster families were also considering this option. However a number of foster parents, for whom the plan was for the child to be adopted by another family, raised concerns about the increasing length of time that the child was remaining within the foster family, and the anticipated difficulties that
may emerge once the child had to move on. These tended to be older foster parents who would ideally have preferred the child to stay with them indefinitely, but were worried that their age would restrict them from being able to provide the best care for the child. *All these foster children had been with their foster families for at least two years.
despite their concerns regarding the disruption that they perceived contact visits to have, most foster parents were involved in negotiating and providing access to birth relatives
“
That was extremely difficult when he came back [from contact with birth mother]. He would have been very hyper, very cheeky, he just really didn’t know what to do. (Foster parent)
”
Some foster parents felt that the disruptive effects of contact visits wore off once a child had settled long-term in a placement; and others also suggested that the age of the child when placed with the foster family was an important factor in determining the impact that contact had upon the child. Children who were placed
22 The Parents Perspectives | From Care to Where? Practitioners’ Report
at a very young age often saw contact simply as being akin to visiting an aunt or uncle, and tended to be less negatively affected. Contact visits often also raised problems for the foster parents themselves. Some felt they were a burden and ‘disturbed the lifestyle’ of the foster family. For others, their wish to protect the child often placed them in a somewhat precarious position.
“
Well I felt over the years I was asked to do things that really I shouldn’t have been asked to do. I was asked to drop the children off with mum and I would have found myself in situations of arriving at mum’s door, and maybe there’d be the smell of alcohol in the house, but not knowing whether she’d drink on her. (Foster parent).
”
The foster parent quoted above was convinced that the contact visits were not in the child’s best interest and put him at risk, particularly when the child had to be left with the birth mother, even though she ‘reeked of drink’. In a similar case, the birth family was granted unsupervised contact visits and, according to the foster parent, the child did not want any contact at all due to bad memories of the birth family. These examples suggest that even though the interest of the child is paramount, children themselves may not be given a voice to express their own wishes about contact. It also reveals the difficult role that the social worker is required to fulfil in trying to support the foster parents while, at the same time, ensuring that the birth parents’ right to have contact with their child, often sanctioned by the Court, is also maintained. Despite their concerns regarding the disruption that they perceived contact visits to have, most foster parents were genuinely involved in negotiating and providing access to the birth family, and some were aware and recognised that the
children may also have happy memories of their birth parents. Some foster parents were positive about contact, and had even invited birth parents or grandparents to celebrate significant occasions for their children with them, such as birthdays, First Holy Communion, and Christmas.
“
If the whole situation was warranted we have let her have sleepovers ... not overdoing it, but just giving that wee bit extra, which maybe would help to gel with the mother and brother, to keep contact alive, you know? It has worked out fairly well up until now .... (Foster parent)
”
What the adoptive parents said: Adoptive parents had a range of contact arrangements for their children. Only one of the adoptive parents interviewed stated that no contact arrangements had been in place at any stage following the adoption. Face-to-face contact with the birth family included contact with birth parents (usually birth mother), either yearly or twice per year, as well as contact with siblings, grandparents and/or extended family, at a frequency that ranged from weekly to yearly. Letter box contact with families was more common. Many of the adoptive parents interviewed described some form of contact with previous foster parents, with face–to-face contact being more common at the start of the placement. This usually took the form of telephone conversations either between the adoptive and former foster parents, or between the foster parents and the child. Whatever the arrangements, adoptive parents felt it was important to have a sense of control or ownership over the contact arrangements. Adoptive parents felt apprehensive about the effect that contact could have on their children. In particular, they were concerned that:
•
The child would be too young to make sense of contact;
•
The child might be upset by parent(s) not availing of contact;
•
Contact may raise some difficult issues for child in the future, including coming to terms with their memories and with the reality of their birth parents not always wanting to avail of contact with them; and
•
Contact with siblings may raise issues such as rough play and jealousy.
“
emotionally [our daughter] can’t cope with (contact) ... something about that particular contact I feel that she just can’t come to terms with (Adoptive parent)
“
”
There’s a bit of jealousy ... We had one contact visit here and that’s not fair on the sibling, because he was obviously seeing what [my son] had and the lifestyle that he had, and it was different. (Adoptive parent)
”
Given the relatively small size of Northern Ireland, some adoptive parents were concerned about maintaining anonymity once contact was in place (in the case of letter-box contact), particularly as children were getting older. Others argued that contact complicated life; and some found that contact raised issues in relation to their parental role identity.
“
Sometimes I feel our life is very crowded ... You’ve got all these complicated extra relationships that other people don’t have ... it just gets very bitty, trying to fit it all in.
(Adoptive parent)
”
From Care to Where? Practitioners’ Report | The Parents Perspectives 23
Adoptive parents also mentioned a range of benefits of contact with the child’s birth parents or previous foster parents. Contact:
•
was seen as a useful source of information on the child and his/her background;
•
was perceived to facilitate an ongoing exchange of information between the child and his/her birth family;
•
helped some adoptive families to ‘gain a granny’ and enjoy the practical and emotional support of the child’s birth family;
•
helped the children to make sense of the key people in their lives;
•
enabled children to gain meaningful memories of their birth parents following the adoption;
•
enabled children to benefit from witnessing a rapport, sense of unity, agreement, and friendship among the key adults in their lives;
•
could reduce feelings of abandonment; and
•
was regarded as helping ease some of the children into the adoptive placement.
“
As I say it’s never an issue, he’s happy to go and see (birth parent) ... and yet if you say to him ‘do you know who you’re going?’ ‘Aye that was my daddy’ ... (Adoptive parent)
”
What the birth parents said: Only a few birth parents were still in contact with their children’s foster parents. One birth mother said that she had problems with a previous foster parent wanting to have continued contact when the child returned home. She said that she had felt hurt by this, but did not feel that she had the strength or authority to deal with this. Other interviewees had contact with foster parents after their children came back home but the contact had eventually stopped. For some birth parents interviewed, contact visits, despite representing the only opportunity to see their children, were emotionally difficult and stressful, particularly when contact sessions were regulated, highly supervised, in awkward and hard-to-reach places, and fairly short in duration. They felt that this often put restrictions on the communication between themselves and their children, and they felt intimidated by the continual surveillance from social workers. However, for one birth parent, contact visits with the child were fairly regular (two days a week) and unsupervised. The child would be picked up in the morning, and spend the whole day with the birth parent.
“
Seeing him like in a wee ... children’s centre up there for an hour in a wee pokey room with somebody sitting watching us ... you weren’t allowed to take them out ... I felt strange when I did visit them. You didn’t know what you could do with them and what you can’t do with them. (Birth parent)
”
References Biehal, N. (2006) Reuniting looked after children with their families. London: National Children’s Bureau. Browne, D. and Moloney, A. (2002) ‘Contact irregular’: A qualitative analysis of the impact of visiting patterns of natural parents on foster placements. Child and Family Social Work, 7, 35-45. Quinton, D., Rushton, A., Dance, C. and Mayes, D. (1997) Contact between children placed away from home and their birth parents: Research issues and evidence. Clinical Child Psychology and Psychiatry, 2(3), 393-413. [end of section]
24 The Parents Perspectives | From Care to Where? Practitioners’ Report
School and friendships Most parents believed their children were getting on well at school, although problems and difficulties with school work were reported. Reasons for these difficulties included: dyslexia, hyperactivity, ADHD, difficulty concentrating and retaining information, missing school due to ill-health, inability to cope with changes of school routine and side effects of medication. They explained how they used different resources to help their children with school; including classroom assistants, extra tuition, support for language, and learning and speech therapy. Where additional support had been provided to the children, improvements had been made.
“
She’s getting help with her reading now and it’s on a one-to-one, so of course one-toone she does brilliantly, so it has
really brought her on and she’s doing really well now with that ... so hopefully that’ll just give her the help that she needs.
”
(Adoptive parent)
“
His speech was quite delayed, we have had appointments with speech therapists, it seemed to click into place last summer, he loves school, settled into P1 so well, we thought we were going to have major behaviour problems but it just didn’t happen. (Foster parent)
”
Adoptive parents, birth parents, and foster parents noted that the children were forming friendships within the family circle, at school, nursery and at various activities, some having ‘lots of friends’ and being ‘a very popular child’. Some
of these children were going to each other’s homes and attending birthday parties. Foster parents said that moving school had made it difficult for the child to make new friends, and both foster parents and birth parents were concerned that the provisions of a Care Order, and the perceived need for police checks, were limiting activities such as ‘sleepovers’. The fact that there is no legislative requirement for these police checks highlights a degree of confusion in relation to parental autonomy, for both foster parents and birth parents in the context of a Care Order.
“
She has a friend who would come on a Friday, she doesn’t really go to the friend’s house because they’d have to be police checked and it’s not really nice to start bringing that into families. (Foster parent)
parents noted that the children were forming relationships within the family circle, at school, nursery and elsewhere
”
From Care to Where? Practitioners’ Report | The Parents Perspectives 25
What support was provided? Support from Social Services was, in general, not initially wanted by many adoptive parents; deemed insufficient (or nonexistent) by most birth parents; and mostly basic by foster parents. Some foster parents said that they did not rely on Social Services support that much, but they felt reassured by the knowledge that support was there if needed. Most felt that the financial support was little more than adequate and far from generous.
“
suppose it meets the needs but only the needs ... you don’t get any money for taking them on holiday, if you’re going on a special holiday or anything like that ... (Foster parent)
”
Most adoptive parents felt support was more intense and frequent at the start but that it petered out afterwards, although they felt that help was still available ‘at the end of the phone’. Many adoptive parents had not needed nor wanted support. They were quite keen to have Social Services out of their lives in the beginning, so that they could get on with a ‘normal’ family life. However, a few adoptive parents whose children had more difficulties (i.e. disabilities, poor health, behavioural problems), were not happy with the level of support available to them.
“
I needed a lot of support and encouragement I think in the early months, just about the way I was feeling and whether that was normal, and that (support) was available for us. (Adoptive parent)
”
“
Since the day your adoption is stamped and sealed that was the end of their job and I’ve never seen her since, or heard anymore ... apparently that’s it. They’re adopted now, the child’s adopted, and that’s your problem. (Adoptive parent)
”
Some birth parents felt that Social Services failed to give them the practical help needed to prevent their children being taken into care in the first place. Most commented that they did not get any support to get their children back. For those parents whose children eventually returned home, many felt Social Services were only concerned about checking up on them, rather than providing practical help. Because of the perceived pressure ‘not to slip up’, some were afraid to ask for support and lived with an ongoing fear of losing their children again. Most said they needed respite care that would give them ‘a break’.
“
It’s just Social Services don’t want to know us now because they say we haven’t given them any more trouble. (Birth parent)
”
While foster parents and adoptive parents tended to have the support of family and friends, many birth parents did not have this source of support and felt that that they had been left to struggle on their own.
“
Because I’m obviously a single parent and her dad’s never been there, my family aren’t there to support her, I feel like I’m having to play the role for so many people ... (Birth parent)
”
many birth parents who did not have the support of family and friends felt that they had been left to struggle on their own
26 The Parents Perspectives | From Care to Where? Practitioners’ Report
Parental stress
Chart 5 Mean scores for adoptive, foster and birth parents
The parents interviewed in this study completed a questionnaire* that measures parental stress in relation to interactions with their children. Chart 5 shows that, compared to foster parents and birth parents, adoptive parents experienced significantly less overall parenting stress, and were significantly more likely to perceive that their child matched their expectations and that interactions with the child were rewarding. Adoptive parents also experienced less distress in their role as a parent to their child, and found their child to be easier to manage. However, a percentage of adoptive and foster parents were found to be experiencing significant problems in relation to parenting stress.
Defensive responding Parental Distress Parent-child dysfunctional interaction Difficult child Total Stress
Adoptive
Foster
Birth
Birth parents experienced very high levels of stress, parental distress, a perception that their child did not meet their expectations, that the parent-child interaction was not rewarding, and that the child was difficult to manage. Implications High levels of parental stress affect the physical and mental health and wellbeing of both parent and child (Kwock and Wong, 2000), parental functioning, the general mood of the home, parental expectations and parent-child interactions (Abidin, 1995; Rogers, 1998). These findings highlight the need for support in relation to these aspects of parenting, and the development of an advocacy service for the parents of children who return home from care. Increased support has been found to reduce parenting stress and to mediate the influence of stress on parenting behaviour (Bonds et al., 2002; McNamara, 2000; Muslow et al., 2002). The findings presented here predate the recent investment in the support of foster parents and the resourcing of foster placements. It will be interesting to see the outcomes of this investment.
parental stress affects parental functioning, the mood in the home and, parental and child physical and mental health
From Care to Where? Practitioners’ Report | The Parents Perspectives 27
However, much of the stress appears to be related to the fundamentals of long-term foster care: the foster parents’ limited autonomy as parents and the essential insecurity of the foster child/foster parent relationship. References Abidin, R. (1995) The Parenting Stress Index Short Form, Third Edition. Odessa, FL: Psychological Assessment Resources. Bonds, D., D., Gondoli, D., M., SturgeApple, M. L. and Salem, L. N. (2002) Parenting stress as a mediator of the relation between parenting support and optimal parenting. Parenting: Science and Practice, 2, 409-435. DHSSPS (2006) Adopting the Future. Belfast: Department of Health, Social Services and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí.
*The Parenting Stress Index/Short-Form (PSI/ SF) measures stress in the parent-child system, and provides a Total Stress score (overall level of parenting stress experienced) in addition to the subscales: •
Defensive Responding (the extent to which the respondent attempts to minimise indications of problems and to present a favourable impression);
•
Parent Distress (the distress an individual is experiencing in his or her role as a parent);
Kwock, S. and Wong, D. (2000) Mental health of parents with young children in Hong Kong: the roles of parenting stress and parenting self-efficacy. Child and Family Social Work, 5, 57-65. McNamara, S. (2000) Stress and young people: What’s new and what can we do? London: Continuum. Muslow, M., Caldera, Y., Pursley, M., Reifman, A. and Huston, A. C. (2002) Multilevel factors influencing maternal stress during the first three years. Journal of Marriage and the Family, 64, 944-956. Rogers, A. Y. (1998) Multiple sources of stress and parenting behaviour. Children and Youth Services Review, 20, 525-546.
•
Parent-Child Dysfunctional Interaction (parents’ perception that their child does not meet their expectations and that the parent-child interaction is not rewarding); and
•
Difficult Child (an indication of parents’ perceptions of child difficulty based on child characteristics; including temperament, defiance, compliance and degree to which the child’s behaviour is demanding).
The normal range of scores is within the 15th to the 80th percentiles. High scores are considered to be scores at or above the 85th percentile. The PSI/SF can be purchased online from: http://www3.parinc.com/products/product. aspx?Productid=PSI-SF
28 The Parents Perspectives | From Care to Where? Practitioners’ Report
Children’s strengths and difficulties
Chart 6 Mean scores from adoptive, foster and birth parents
The birth parents, adoptive parents, and foster parents interviewed also completed a questionnaire* that evaluates children’s pro-social behaviour, and behavioural and emotional problems that they might have.
Emotional symptoms Conduct problems Hyperactivity/Inattention
Chart 6 shows that all the parents thought their children were considerate of others, helpful and kind (pro-social behaviour scale). Pro-social behaviour: scored within normal range
• • •
Peer relationship problems Pro-social behaviour
Adoptive
Foster
Birth
Total Difficulties
100% of adopted children 80% of foster children 8 of 9 birth children
Children who had been returned to their birth parent/s appeared to have more difficulties than the adopted and fostered children in terms of behaviour problems, hyperactivity and overall difficulties. However, a significant number across all three groups showed signs of hyperactivity, behaviour problems and overall difficulty (see table 3). Such difficulties clearly impact upon functioning, particularly in relation to educational attainment, and may also place strain upon the success of the placement itself. Implications The high Strengths and Difficulties (SDQ) scores elicited from parents suggest that some children have serious levels of emotional and behavioural problems. The findings reflect other research evidence that children in care experience high levels of difficulties. For instance, in Teggart and Menary’s (2005) study, 31 children in public care, aged 4 to 10 years old, were assessed by their carers and teachers as having higher levels of emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and as having fewer pro-social behaviours, relative to age appropriate norms.
Table 3 Difficulties: scored higher than the norm Hyperactivity /Inattention
Conduct Problems
Total Difficulties
Adopted group
65%
33%
33%
Foster Group
75%
52%
44%
Birth Group
9
9
5
Meltzer and colleagues (2003) found that children in care but living with their birth parents were more likely to be assessed as having a mental disorder and were more likely to have anxiety disorders and depression than those in foster care (20% and 9% compared to 8% and 2%). The emphasis in child care policy and practice particularly since the Children (NI) Order 1995 has been on keeping children at home and returning them to their families wherever possible, if they do come into care. This is based on the belief that it is generally best for children to be with their families with minimum interference from the state. The findings presented here indicate some limitations of this policy direction. The children who returned home had the most, not the least, difficulties and their
parents were having the most difficulty coping. In light of these findings, Health and Social Care Trusts and other relevant care agencies need to review the support structure for families when children return home from care. Again, the findings highlight the need for the development of an advocacy service for parents whose children return home from care. The high Strengths and Difficulties (SDQ) scores elicited from some of the adoptive parents are a reminder that adoption is not a ‘magic wand’. Children increasingly come to adoption with a range of emotional, behavioural and health problems and adoptive parents, who often come to adoption because they cannot have birth children (Kelly et al., 2007), may be sorely
From Care to Where? Practitioners’ Report | The Parents Perspectives 29
tested. The love and security on offer in an adoptive home will often need to be supplemented with accessible post-adoption services. This has been recognised in the Government’s strategy for the development of the adoption service (DHSSPS, 2006).
All these findings highlight the need for increased postplacement support targeted at families with greatest need, particularly when children return home to their birth parents.
* The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioural screening questionnaire completed by parents for assessing children and adolescents. It is composed of 25 items divided into 5 scales: •
•
emotional symptoms (complains of headaches/stomach aches, often worried, unhappy, downhearted, nervous/clingy in new situations, many fears/easily scared); conduct problems (temper tantrums, disobedient, fights with/bullies other children, lies/cheats, steals);
References Children (NI) Order 1995. Belfast: Stationary Office. (available from: http://www.opsi.gov.uk/si/si1995/ uksi_19950755_en_1) Kelly, G., Haslett, P., O’Hare, J. and McDowell, K. (2007) Permanence planning in Northern Ireland: A developmental project. Adoption & Fostering, 31(3), 18-27. DHSSPS (2006) Adopting the Future. Belfast: Department of Health, Social Services and Public Safety. An Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí. (available from: http://www.dhsspsni.gov.uk/ adopting_the_future_16-6-06pdf.pdf )
•
hyperactivity/inattention (restless, overactive, constantly fidgeting/squirming, easily distracted, poor concentration and task completion);
•
peer relationship problems (solitary, picked on/bullied by other children, gets on better with adults than other children); and
•
pro-social behaviour (considerate, shares readily, helpful, kind).
A total difficulties score is based on the combined scores of each of the scales, except
Meltzer, H., Corbin, T., Gatward, R., Goodman, R. and Ford, T. (2003) The Mental Health of Young People Looked After by Local Authorities in England. London: Office of National Statistics. Teggart, T. and Menary, J., (2005) An investigation of the mental health needs of children looked after by Craigavon and Banbridge Health and Social Services Trust. Child Care in Practice, 11.1, 39-49.
the pro-social scale. An impact score provides information on distress or impairment to home life, friendships, classroom learning and/or leisure activities as a result of difficulties. The scores on each scale can be classified as normal, borderline or abnormal. The SDQ is available free online from: www.sdqinfo.com <http://www.sdqinfo.com>
Methodology
Four sources of data were used: 1. SOSCARE (Social Services Client Administration and Retrieval Environment) data Data was provided for the full population on 31st March 2000 and again on 31st March 2002. The SOSCARE data provided general information such as date of birth and gender, and also a detailed account of each child’s placement history since they entered care until 31st March 2002. The 11 Health and Social Service Trusts provided information regarding where all the children were living (whether in foster care, with birth parents, etc.) at 31st March 2004. 2. Case file data The case files of each child were examined after 31st March 2000, to cover the period up to that point, and after 31 March 2002, to cover the two-year period. They provided information on factors such as reason(s) for entry into care, child and family background and characteristics, details regarding child health or behaviour problems, and developmental delays. NIGALA (Northern Ireland Guardian Ad Litem Agency) checked the status of the population in terms of dates of adoption between 2000 and 2002. 3. Interview data Semi-structured interviews were conducted with the foster parents of 56 foster children, the adoptive parents of 51 adopted children, and the birth parents of 9 children returned to birth parents. All foster, adoptive, and birth parents (of children returned home) in the study were approached for interview, and this reflects the number of parents who agreed to be interviewed. Although considerable efforts were made to recruit as many birth parents as possible, the low number of interviews reflects the fact that they are a very hard to reach group.
From Care to Where? Practitioners’ Report | Methodology 31
A key focus of interest was a comparison between those children who were either adopted or in long-term foster care. Therefore, for the purposes of this report summary, only those foster interviews where the child had been placed for longer than two years, and where the care plan was not considering adoption as of March 2002, were selected for detailed analysis. Twenty met these criteria. Consequently, 20 adoptive interviews were randomly selected for comparison. The analysis of the remaining interview data will inform future publications. Given the low number of interviews that were conducted with birth parents of children who had been returned home from care, all were analysed. 4. Standardised Measures During the interviews, parents also completed two questionnaires: Goodman’s (1997) Strengths and Difficulties Questionnaire (SDQ) and Abidin’s (1995) Parenting Stress Index – Short Form (PSI-SF). The SDQ is a questionnaire that evaluates children’s pro-social (helpful) behaviour, as well as behavioural and emotional problems they might have. The PSI/SF aims to measure parental distress, parent-child difficult interaction, and difficulties with the child. Event History Analysis: EHA was used to attempt to understand what factors predict different care pathways for younger children in care, and to what extent Event History Analysis is a term for a range of procedures that allows for examination of the amount of time elapsed before a certain event occurs, and tries to explain why some children are at a higher/lower risk of experiencing an event than others.
For Event History Analysis, it is important to specify the exact point in time that the transition between states, defined as an event, occurs. This is relatively straightforward in relation to adoption; there is a definable movement from not being adopted to the making of an Adoption Order; and in relation to returning home to birth parents; there is a definable move from not living with birth parents to living with birth parents. However in the case of foster care, the child remains essentially in the same state. Although there tends to be a transition between short and longterm foster care, it is often very difficult to specify when this occurs. Therefore, Event History Analyses were conducted solely in relation to adoption and return to birth parents. Ethical considerations Access and consent: Prior to conducting the interviews, we provided each Trust with the SOSCARE number of each child in the population that fell within their jurisdiction, and asked the Trusts to return names and addresses of the current parents of these children. Parents were then sent an information sheet and a letter outlining the purpose of the study and what would be involved upon agreeing to participate in an interview. The letter also specified a date and time at which a researcher could visit to conduct an interview and asked the parent to contact the research team if they did not want to take part or if the date and time specified were not suitable. Letters were followed up by telephone calls in order to ensure that the parents were happy to proceed prior to a researcher visiting their home. Informed consent was obtained from each participant at the start of the interview.
32 Methodology | From Care to Where? Practitioners’ Report
Privacy, confidentiality and anonymity: At the start of each interview, the researcher outlined that responses would be presented in aggregate form, in peer reviewed journal articles and a final report, in a manner that would not reveal the identity of any individual or organisation. Participants were assured that they could refuse to answer any question or line of questioning that they did not wish
to pursue throughout the course of the interview. All stages of the research were carried out in accordance with the Data Protection Act 1998, Queen’s University Belfast (QUB) Code of Good Conduct in Research (2003), and the QUB Data Protection Policy. Data was stored on password protected QUB computers in anonymised form and access to the data was restricted to the research team.
References Abidin, R. (1995) The Parenting Stress Index Short Form, Third Edition. Odessa, FL: Psychological Assessment Resources.
Useful Web Sources
Childlink (a fast growing innovative online database focusing on Legislation, Policies and Practices regarding children, young people and families who live in the UK and Ireland):
Northern Ireland Guardian Ad Litem Agency (NIGALA): http://www.nigala. hscni.net/
Adoption UK: http://www.adoptionuk. org/ Barnado’s NI: http://www.barnardos. org.uk/northernireland/ British Association for Adoption and Fostering (BAAF): http://www.baaf.org. uk/local/ni/index.shtml Care Pathways and Outcomes: website of this research project
http://www.qub.ac.uk/cpo
The next stage The interviews with the adoptive, foster, and birth parents gave us a sense of how the children seem to be getting on. But how do the children themselves feel they are getting on? How has their care experience impacted on their lives? Where do they consider ‘home’? How do they feel regarding their sense of belonging? How do they feel about contact?
http://www.childlink.co.uk/about_ us.php Children’s Law Centre (based in Northern Ireland): http://www. childrenslawcentre.org/index.html
Goodman, R. (1997) The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581-586.
Institute of Child Care Research, Queen’s University Belfast: http://www.qub.ac.uk/researchcentres/InstituteofChildCareResearch/ Voices of Young People in Care (VOYPIC): http://www.voypic.org/
Northern Ireland Commissioner for Children and Young People (NICCY): http://www.niccy.org/
The current phase of the study, The Children’s Perspective, aims to look at these questions through interviews with groups of adopted, fostered, and returned home children, and their parents and carers.
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Report Authors: Dominic McSherry, Emma Larkin, Montse Fargas, Greg Kelly, Clive Robinson, Geraldine Macdonald, Dirk Schubotz and Rosemary Kilpatrick
Study Title: Care pathways and outcomes: Following a population of children who were under five years old and in care in Northern Ireland in 2000.
www.qub.ac.uk/cpo
Report Title: From care to where? A care pathways and outcomes report for practitioners
CDS N111329
November 2008
ISBN 9780853899464