Transcript Neglected Children & their Families

Neglected Children & their Families
“What do we know and what can we do?”
Olive Stevenson
Emeritus Professor of Social Work
University of Nottingham
and
Sara Glennie
Independent Consultant
Some Key Issues
•Understanding the concept of neglect in relation to child
development and its evidence base.
•Appraisal of parenting capacity in relation to the developmental
timetable of the children.
•Timely decisions regarding the adequacy of children’s care at home.
•Acceptance by all responsible that, if left at home, monitoring
and/or intervention is likely to be long term.
Key Issues cont.
•Understanding the complexity of working with parents and other
professionals in cases of long term neglect.
•Recognition by workers and their managers/seniors of the
emotional strain such families place on those in the field.
•Working to improve the understanding of neglect within the legal
profession.
•Working to develop complementary care for children who remain
with their families.
New Evidence and Policy Trends
since 2007…
•Rutter
•Wade
•Farmer &Lutman
•Demos: In Loco Parentis
Full References
Rutter et al, English and Romanian Adoptees(ERA) Study: 45
Key Questions. BAAF. 2009
Wade, J., Biehal N., Farrelyn N. and Sinclair, I. University of
York SPRU Report. January 2010 DCSF 2392
Farmer,E and Lutman,E. Case Management and Outcomes for
Neglected Children Returned to their Parents: A Five Year
Follow-up Study. DCSF-RB214
Hannon, C. Wood C and Bazelgette,L. In Loco Parentis, Demos
Policy and Practice Implications from the
ERA Study (Rutter et al. 2009)
Relevance to children neglected in their own homes.
The ERA Study:
1. A comparative longitudinal study of children adopted into families in England
between February, 1990 and September, 1992 – aged 42 months or younger at
time of entry to UK.
2. Special focus on 98 children whose institutional care (in Romania) had
continued until at least age 6 months, in contrast to 119 children comprised as
follows:
• 51 adopted in UK not in institutions
• 21 from Romania, not in institutions
• 46 not in institutions after age 6 months.
3. Extensive assessment at 4,6,11 and 15 years.
Are there reliable pointers to good
outcomes? (Rutter et al.)
1.
2.
3.
“The most important prediction factor of later psychological problems was
the age of the child when leaving institutional care”. (p.8). “Between the age
of 6 and 8 months appears to be a watershed, though not absolute and
categorical. Half the 98 children in the sample showed long term persisting
problems – so half did not! But these children overall did less well than those
in the control group.”
Evidence of very early beginnings of language (NB what constitutes
“beginnings of language” in these early months?) Any language at all was
associated with better cognitive outcomes.
Psycho-social deprivation and sub-nutrition both had major deleterious, longlasting effect on head growth – more than other forms of growth. Even when
sub-nutrition was not present, psycho-social deprivation had massive
deleterious effects. (pp 14-15)
Particular Psychological Problems
closely associated with Institutional
Deprivation (Rutter et al.)
Disinhibited attachment problems
2. “Quasi-autistic” features – i.e. alterable in different
circumstances
3. Inattention/overactivity
4. Intellectual impairment
Slow improvement up to final assessment at 15 years. But, often
turned some difficulties into assets, eg. Re: quasiautistic,musical/athletic prowess; re: disinhibition, lack of shyness
can be a social asset. NB link to work on resilience.
1.
Outcomes for Children Looked After for Reasons of
Abuse or Neglect: The Consequences of Staying in
Care or Returning Home ( Wade et al 2010)
Key Points in relation to Neglect (Chapter 16)
1.
2.
3.
Outcomes vary according to LA and teams within same LA; you can
make a difference!
.“…where neglect had contributed strongly to a child’s admission,
children were less likely to have returned, less likely to have wanted to
return and were rather more likely than other maltreated children to
be rated as having settled well in care.” (p.241-242)
Planning for return home, especially with care orders, is of great
importance. However, quality of planning was found to be variable.
Child Wellbeing at Follow-up:
“the clearest findings concerned neglected children”
(Wade et al 2010 cont. )
4. “Where there had been strong evidence of preadmission neglect, and
even taking account of other factors,…these children did best if they
remained in care. Those who went home tended to fare worse than
other maltreated children.”
5. “Where children have experienced chronic and serious neglect, extreme
caution should surround a decision for unification...these children did
significantly worse if they went home…for neglected children
particularly, remaining in care was an almost unequivocal good.”
6. Research found many children spoke fondly of foster parents and well
about other experiences in care.”
pgs. 246-249
Case Management and Outcomes for
Neglected Children Returned to their
Parents (Farmer and Lutman, 2010)
•Outcomes for younger children were much better than for older children. The cut
–off age was six at the time of re-unification, after which action to safeguard
children and plan for their future reduced. Practice with older children and
adolescents needs to be more proactive.
•In two fifths of cases, children who were subject to CP Plans were not adequately
safeguarded. Plans made during care proceedings did not work out in three fifths
of cases – often when children were returned to parents because of an overoptimistic view of the possibility of parental change by guardians and expert
assessors, in the face of long histories suggesting the contrary.
•There were major LA variations in how proactively cases were managed, leading
to better outcomes in some authorities than others.
Three questions to think about:
What can we learn from Serious Case Reviews
nationally that will support our work with children
who are neglected?
What can we learn from our own Serious Case
Reviews?
Do we need to think differently about working
together when we share responsibility for children
who are neglected?
Neglect in Oxfordshire:
the current picture (1st July 2010)
Learning from Serious Case
Reviews: a cautionary note.
The imperative is political , and….
The population studied is idiosyncratic, not representative of day to
day safeguarding practice.
 The study is necessarily descriptive and retrospective
Causal connections cannot be made.
 There is no matched sample with different outcomes
“…more does need to be known about routine child protection work and its
effectiveness. ..comparisons could be made between Serious Case Reviews and
matched cases with a similar profile but different outcome…”
Biennial Analysis of Serious Case
Reviews: 2005-2007 Brandon et al
… to draw out key themes and trends and their implications for
policy and practice”.
4th biennial analysis of SCRs in England
o Sinclair and Bullock (1999-2001)
o Rose and Barnes (2001-2003)
o Brandon et al (2003-2005)
Layered approach – intensive sample of 40 SCRs
Ecological-transactional perspective
Emergent themes that have
particular relevance to working
with neglect
Chaotic behaviour in families can be mirrored in professional
thinking and action
Both families and professionals can fail to see the child
Professionals overwhelmed by the volume and nature of work
75% of families did not cooperate with services
Past or present domestic violence and/or parental mental ill health
and/or parental substance misuse in almost 75% of intensive sample.
Local echoes…
Chaotic conditions
The impact of substance misuse on parenting
The challenge of co-operation, compliance and
deception
Difficulty in seeing and reading the experience of
the child
…and further learning about
Inter-agency relationships
Managing our hope and optimism
The nature of “evidence” in relation to
neglect
Do we need to work together
differently?
System consensus across 4 domains
Common tools lead to common assessments
Forums that enable the “why?” question
The critical role of core groups