Widening our knowledge concerning young looked after children: the case for research using sociological models of childhood

The Assessment and Action framework for looked after children, designed to improve outcomes for all children in public care and those at home on care orders, is now well established in the UK. This paper offers a critical evaluation of the framework by examining the model of childhood upon which it is premised and by exploring its relationship to children's rights as conceptualized in the United Nations Convention on the Rights of the Child (1989). It will be argued that the particular child development model which underpins the framework addresses the rights of looked after children to protection and provision but does not allow for their participation rights to be sufficiently addressed. A critical review of the research concerning the education and health of looked after children is used to illustrate these points. It will be argued that what are missing are the detailed accounts of looked after children themselves. It is concluded that there is a need for the development of additional research approaches premised upon sociological models of childhood. These would allow for a greater engagement with the participation rights of this group of children and complement the pre-existing research agenda

Adoption from Care in Northern Ireland: Problems in the process

This is a study of the processes for freeing children for adoption in Northern Ireland. The focus was the time taken from admission to care to adoption order. The findings confirmed that the process is dogged by delay at each stage. In total the average time from the child becoming looked after to the granting of an adoption order was 4.5 years. Most of the time taken was in the stages for which social services had lead responsibility, principally the decision to pursue adoption as the plan for a child. The children were very young when admitted to care - average age 1 year 7 months. Most were admitted to care because they were being neglected. Their parents were well known to social services and had multiple problems. Most parents unsuccessfully contested the social services' application and this contributed much to the delay. Their former foster parents adopted almost half of the children and these children tended to be placed more quickly with their adopters than those placed with adopters who were not their foster parents prior to the adoption process.

Psychological problems in children with cerebral palsy: A cross-sectional European study

Objectives: To describe psychological symptoms in 8–12-year-old children with cerebral palsy; to investigate predictors of these symptoms and their impact on the child and family.

Design: A cross-sectional multi-centre survey.

Participants: Eight hundred and eighteen children with cerebral palsy, aged 8–12 years, identified from population-based registers of cerebral palsy in eight European regions and from multiple sources in one further region.

Main outcome measures: The Strengths and Difficulties Questionnaire (SDQ)P4-16 and the Total Difficulties Score (TDS) dichotomised into normal/borderline (TDS = 16) versus abnormal (TDS > 16).

Statistical analysis: Multilevel, multivariable logistic regression to relate the presence of psychological symptoms to child and family characteristics.

Results: About a quarter of the children had TDS > 16 indicating significant psychological symptoms, most commonly in the domain Peer Problems. Better gross motor function, poorer intellect, more pain, having a disabled or ill sibling and living in a town were independently associated with TDS > 16. The risk of TDS > 16 was odds ratio (OR) = .2 (95% CI: .1 to .3) comparing children with the most and least severe functional limitations; OR = 3.2 (95%CI: 2.1 to 4.8) comparing children with IQ < 70 and others; OR = 2.7 (95% CI: 1.5 to 4.6) comparing children in severe pain and others; OR = 2.7 (95% CI:1.6 to 4.6) comparing children with another disabled sibling or OR = 1.8 (95%CI: 1.2 to 2.8) no siblings and others; OR = 1.8 (95% CI: 1.1 to 2.8) comparing children resident in a town and others. Among parents who reported their child to have psychological problems, 95% said they had lasted over a year, 37% said they distressed their child and 42% said they burdened the family at least ‘quite a lot’.

Conclusions: A significant proportion of children with cerebral palsy have psychological symptoms or social impairment sufficiently severe to warrant referral to specialist services. Care must be taken in the assessment and management of children with cerebral palsy to ensure psychological problems are not overlooked and potentially preventable risk factors like pain are treated effectively. The validity of the SDQ for children with severe disability warrants further assessment.

Common psychology problems in cerebral palsy

Cerebral palsy (CP) refers to a collection of motor impairments which result in abnormal posture and movement following an insult or damage to the developing brain. Psychological adjustment in children with CP is under researched with little population-based or longitudinal data, but there is sufficient evidence to suggest that children with CP are at increased risk for psychological problems. The types of difficulties they experience include emotional, hyperactivity and peer problems with conduct disorder being more prevalent in mildly affected children. The origins of psychological problems in this group are complex but include ‘disease’ and ‘psychosocial’ factors related to having a brain-based disability in the family, as well as other factors that influence adjustment in all children. There are no intervention studies in children with CP aimed at preventing psychological problems or promoting mental wellbeing. However, evidence from other work suggests it is possible to work with the child and family to develop skills, manage symptoms, and build confidence and resilience. Acting as early as possible has been found to be beneficial for bonding, child development and reducing parental anxiety.

Young children returning home from care: The birth parents' perspective

While a wide range of literature exists on the experiences of children in foster care or adoption, much less is known about children who return home from care to their birth parents. This paper focuses on the perspectives of a small sample of birth parents of young children who returned home from care. It draws on findings from the Northern Ireland Care Pathways and Outcomes Study that has been following a population (n = 374) of children who were under 5 years and in care in Northern Ireland on the 31st of March 2000. As part of this study, interviews were conducted with 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. The paper explores the birth parents’ views on how they coped while their child was in care, how they were coping after the child had returned home and how their child was faring at home. Results revealed that these parents, and their children, were experiencing multiple difficulties and struggled to cope after the children had returned home.

To what extent do children with cerebral palsy participate in everyday life situations?

The aims of the study are to describe participation of children with cerebral palsy in everyday life situations, to investigate the relationship between participation (primary outcome variable) with child and parent characteristics (independent variables) and to compare the frequency of participation (secondary outcome variable) of children with cerebral palsy with children without disabilities. A cross-sectional survey of parents of children with cerebral palsy in Northern Ireland was undertaken in families’ homes using standard questionnaires. Children with cerebral palsy born between 31/8/1991 and 1/4/1997 were identified from a case register of people with the condition. A total of 102 parents opted in (51% response rate). Questionnaires included the Life Habits Questionnaire (Life-H) to measure difficulties in participation and The Frequency of Participation Questionnaire (FPQ), to measure frequency of participation with comparative data for children without disability. Overall, children with cerebral palsy participated less often than their non-disabled peers across a number of lifestyle and cultural pursuits. Among the 102 children with cerebral palsy, participation in ‘relationships’ was the least disrupted area of everyday life and aspects of ‘school’, ‘personal care’ and ‘mobility’ were the most disrupted. Children with cerebral palsy and severe co-impairments were significantly less likely to experience higher levels of participation in most areas of everyday life when compared to children with cerebral palsy and no severe co-impairments. Child physical and psychological well-being did not influence participation although higher parenting stress was significantly related to lower child participation in ‘community activities’. Participation is an important health outcome for children with cerebral palsy and should be incorporated in routine clinical practice. Professionals have a role to play both at the level of addressing individual child and family needs as well as influencing legislation and policy to ensure improved access to services and local communities.

Looking again at troubled families: parents' perspectives on multiple adversities

The 'Troubled Families' policy and intervention agenda is based on a deficit approach that tends to ignore the role of structural disadvantage in the lives of the families it targets. In an effort to support this rhetoric, both quantitative and qualitative data have been used, and misused, to create a representation of these families, which emphasizes risk and individual blame and minimizes societal factors. This current paper presents findings from an in-depth qualitative study using a biographical narrative approach to explore parents' experiences of multiple adversities at different times over the life-course. Key themes relating to the pattern and nature of adversities experienced by participants provide a more nuanced understanding of the lives of families experiencing multiple and complex problems, highlighting how multiple interpretations are often possible within the context of professional intervention. The findings support the increasing call to move away from procedurally driven, risk averse child protection practice towards more relationally based practice, which addresses not only the needs of all family members but recognizes parents as individuals in their own right.

Maternal Religiosity, Family Resources and Stressors, and Parent-Child Attachment Security in Northern Ireland

This study explores the associations between mothers' religiosity, and families' and children's functioning in a stratified random sample of 695 Catholic and Protestant motherchild dyads in socially deprived areas in Belfast, Northern Ireland, a region which has experienced centuries of sectarian conflict between Protestant Unionists and Catholics Nationalists. Findings based on mother and child surveys indicated that even in this context of historical political violence associated with religious affiliation, mothers' religiosity played a consistently positive role, including associations with multiple indicators of better family functioning (i.e., more cohesion and behavioral control and less conflict, psychological distress, and adjustment problems) and greater parentchild attachment security. Mothers' religiosity also moderated the association between parentchild attachment security and family resources and family stressors, enhancing positive effects of cohesion and mother behavioral control on motherchild attachment security, and providing protection against risks associated with mothers' psychological distress. Findings are discussed in terms of implications for understanding the role of religiosity in serving as a protective or risk factor for children and families.

Substance Use and Misuse : Adolescent Substance Use in the context of the family ; a qualitative study of young people's views on parent child attachments , parenting style and parental substance use

Introduction and Aims. While the role of the family in adolescent substance use has been well documented, few studies have attempted to explore in-depth youth perceptions of how these familial processes/dynamics influence teenage substance use. This paper reports the findings from a study exploring risk and protective factors for teenage substance use within the context of the family as perceived by young people with a view to informing current and future family based prevention and education interventions.
Design and Methods. Data collection took place in nine post-primary schools across Northern Ireland. Nine focus groups using participatory techniques were facilitated with a purposive sample of sixty-two young people (age 13-17 years). Data were transcribed verbatim and analysed using a content/thematic analysis.
Results. Three broad themes/aspects of the family emerged from the data, which may serve to protect or attenuate the risk of substance use among young people. Parent-child attachment was a major theme identified in protecting adolescents from substance use in addition to effective parenting particularly an authoritative style of parenting supplemented by parental monitoring and good parent-child communication to encourage child disclosure. Family substance use was deemed to impact on children’s substance use if exposed at an early age and the harms associated with PSM were discussed in detail.
Discussion and Conclusions. The qualitative approach provides insight into current understanding of youth perceptions of substance use in the context of family dynamics. A number of recommendations are outlined. Family based (preventive) interventions/parenting programmes may benefit from components on effective parenting including authoritative styles, parental monitoring, effective communication, spending time together (building attachments), parent-child conflict, adolescent development and factors which impact on parenting. Parenting programmes tailored to mothers and fathers may be beneficial. School based interventions targeting children/adolescents may be best placed to target children living with parental substance misuse.
Keywords: substance/substance related disorders, focus groups, young people/adolescent,

Adolescent substance use in the context of the family: a qualitative study of young people’s views on parent-child attachments, parenting style and parental substance use

Background: Adolescent substance use can place youth at risk of a range of poor outcomes. Few studies have attempted to explore in-depth young people’s perceptions of how familial processes and dynamics influence adolescent substance use.
Objectives: This paper aimed to explore risk and protective factors for youth substance use within the context of the family with a view to informing family based interventions.
Methods: Nine focus groups supplemented with participatory techniques were facilitated with a purposive sample of sixty-two young people (age 13-17 years) from post-primary schools across Northern Ireland. The data were transcribed verbatim and analysed using thematic analysis.
Results: Three themes emerged from the data: 1) parent-child attachments, 2) parenting style and 3) parental and sibling substance misuse. Parent-child attachment was identified as an important factor in protecting adolescents from substance use in addition to effective parenting particularly an authoritative style supplemented with parental monitoring and strong parent-child communication to encourage child disclosure. Family substance use was considered to impact on children’s substance use if exposed at an early age and the harms associated with parental substance misuse were discussed in detail. Both parent and child gender differences were cross-cutting themes.
Conclusion: Parenting programmes (tailored to mothers and fathers) may benefit young people via components on authoritative styles, parental monitoring, communication, nurturing attachments and parent-child conflict. Youth living with more complex issues, e.g. parental substance misuse, may benefit from programmes delivered beyond the family environment e.g. school based settings.

Information sharing and reporting systems in the UK and Ireland: Professional barriers to reporting child maltreatment concerns

Across the UK recent policy developments have focused on improved information sharing and inter-agency cooperation. Professional non-reporting of child maltreatment concerns has been consistently highlighted as a problem in a range of countries and the research literature indicates that this can happen for a variety of reasons. Characteristics such as the type of abuse and the threshold of evidence available are key factors, as are concerns that reporting will damage the professional-client relationship. Professional discipline can also impact on willingness to report, as can personal beliefs about abuse, attitudes towards child protection services and experiences of court processes. Research examining the role of organisational factors in information sharing and reporting emphasises the importance of training and there are some positive indications that training can increase professional awareness of reporting processes and requirements and help to increase knowledge of child abuse and its symptoms. Nonetheless, this is a complex issue and the need for training to go beyond simple awareness raising is recognised. In order to tackle non-reporting in a meaningful way, childcare professionals need access to on-going multidisciplinary training which is specifically tailored to address the range of different factors which impact on reporting attitudes and behaviours.