Gathering PACE 201716 November

The Lighthouse, Glasgow

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Welcome and introduction

Professor Jennifer DavidsonExecutive Director

Inspiring Children’s Futures

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Address by the Minister

Maree Todd MSPMinister for Childcare and Early Years

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Setting

the sceneJason Leitch

National Clinical Director

(Healthcare, Quality and Strategy)

Scottish Government

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Nina Biehal Department of Social Policy and Social Work

University of York

nina.biehal@york.ac.uk

What do we mean by permanence for children

accommodated away from home?

Need to consider both

Objective permanence

• Physical and legal stability

Subjective permanence

• Involves child’s emotional security and sense of belonging

• ‘Perception of permanence is key’ (Lahti 1982)

• Do children and caregivers both view the placement as

permanent?

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A definition from English government guidance

‘Permanence is the framework of emotional permanence

(attachment), physical permanence (stability) and legal

permanence (the carer has parental responsibility for the

child) which gives a child a sense of security, continuity ,

commitment and identity. The objective of planning for

permanence is therefore to ensure that children have a

secure, stable and loving family to support them through

childhood and beyond. (My italics)

Children Act 1989 Guidance and Regulations: Care Planning, Placement

and Case Review (2010)

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1. Findings from University of York study Belonging and

Permanence: compared children in foster care (including

kinship foster care) those adopted

Compared objective permanence

Compared mental health and educational progress of

children on different pathways

Explored subjective perceptions of permanence for

children in long-term foster care

2. Will briefly introduce our ongoing Permanently

Progressing? study in Scotland

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Belonging and Permanence study (2010)

In 2001 we identified 196 children who had been in same foster placement for 3+ years or

adopted from care

By 5 year follow-up (2006) there were 3 groups 39% adopted from care

32% in stable foster care (in same placement 7-12 years)

• 1/3 of these were in kinship foster placements

23% experienced unstable care (1 or more moves since

previously stable placement)

Methods Postal surveys of children’s social workers and foster carers or

adoptive parents

Focus groups with social workers, team managers, adoptive

parents and foster carers 9

Higher disruption rate for foster placements, even for apparently

stable placements

28% of the previously stable foster placements disrupted

11% of children placed for adoption/adopted

Other studies have found

High disruption rates for foster care: 17-50% (depending on

age at placement and other factors)

Very low disruption rates for adoption (Selwyn et al 2012)

• 3.2% of 37,335 adoptions disrupted over 12 years

• Disruption mainly occurred in adolescence

• Varied a lot by local authority

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Children accommodated at a younger age were more likely to be

adopted

Age when last entered care (Belonging and Permanence study)

Adopted 1.6 years

Stable foster care 3.8 years

Unstable care 4.9 years

Late admission reduced children’s chance of adoption

59% children adopted by strangers entered care before age 1

But fewer children adopted by carers entered before age 1

Late admission increased the risk of placement instability

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Mix of child, foster carer and agency factors (B & P study)

The child Later admission to care - longer exposure to abuse, neglect,

other adversities at home may have impact on emotional &

behavioural development

Child may be more difficult to care for if enters care when older

The foster carer Circumstances changed – some gave up fostering due marriage

breakdown, bereavement, domestic violence

Lack of legal permanence - no legal commitment to child when

carers’ circumstances changed

The local authority

Response to emerging placement difficulties?

Support to placement?12

Used a standardised measure of emotional and behavioural

difficulties (SDQ) to compare mental health of the 3 groups

completed by adoptive parent or foster carer

Scoring above clinically significant threshold no different for

children adopted or in stable foster placements

Stable foster care 36%

Adopted 35%

Unstable care 54%

General population 10%

‘Unstable’ group at higher risk of mental health difficulties

At least 50% of disruptions triggered by behaviour problems

Impact of delay on mental health: those who entered placement

after age 4 had higher scores on SDQ

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Scores from 5 years earlier were available for 82 children

Those whose index placements subsequently broke down

(unstable group) already had higher SDQ scores beforehand

No significant change in scores over past 5 years

Lack of change suggests emotional and behavioural

difficulties are strongly influenced by pre-care adversity

Unstable care group entered care much later

Had longer exposure to adversity

• Other studies show that this reduces ability to recover from

impact of abuse and neglect

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Measured carers’ and adopters’ parenting style

Measures of child orientation, family integration, rejection

(completed by foster carers/adoptive parents)

Ratings of parenting (social workers)

Foster carer scores for family integration/rejection

correlated with social worker ratings of parenting

Children with higher SDQ scores less likely to be

perceived as integrated into the foster family (by carers)

Rejection scores for previous carers of unstable group

(in 2001) higher if children had high SDQ scores then

(i.e. before last placement disrupted)

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Interaction of child disturbance and parenting style

Behavioural and attachment difficulties can make

child more difficult to care for

May elicit carer rejection

Can lead to downward spiral: rejection or lack of

warmth/responsiveness to child may reinforce

emotional and behavioural difficulties

Carer commitment to the child was key

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Combined measure of school progress, attendance,

exclusion and behaviour showed:

Better overall integration and progress for children in

permanent placements

Stable foster care as well as adoption

Unstable care group doing worse on overall measure

More likely to be excluded or truant in last 6 months

Children likely to be doing worse if they

Had high scores on SDQ (esp. if high for hyperactivity)

Were disabled

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Other comparative studies at York have highlighted risk of

impermanence in foster care and also its potential

Study of 595 children in foster care found impermanence

sometimes due to repeated attempts to return child home even

when not in their best interests (Sinclair et al 2005)

Study of 149 children accommodated due to abuse/neglect,

and either reunified with parents or remained in foster care

2/3 reunified children returned to care 1, 2 or more times, foster care

group was more settled

Outcomes more positive for those who remained in foster care

Children in foster care were more likely to have positive wellbeing

and less likely to be involved in crime or substance misuse than

those reunified with families (Wade et al 2011; Biehal et al 2014).

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Subjective permanence was important too

Interviewed 37 children in Belonging and Permanence

study and their foster carers or adoptive parents

Used a range of methods to explore

Relationships with adoptive and foster families

Relationships with birth parents

Perceptions of permanence – a family for life?

Child’s sense of belonging

Some findings in relation to children in stable foster

placements………………

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Ideas about ‘family’ and ‘belonging’ were complex and could shift over time

Some children were preoccupied with birth parents

½ of stable foster care group, ¾ of unstable care group

A key factor in sense of belonging was how child located the foster family in relation to the birth family

Feelings of hurt, anger, ambivalence about parents sometimes linked to ambivalence towards carers

‘Chemistry’ between child and carer and carer’s love/ commitment to child despite difficulties were also key

also found in fostering studies by Ian Sinclair, Gill Schofield, and Mary Dozier

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Some parents physically present (in contact), but unreliable

or rejecting, so their psychological presence was troubling

How far can fostered children mentally process their

experience and knowledge of parents?

How does their ‘story’ explaining parents’ past and current

actions represent their parents - and themselves – to them?

How far can they resolve complicated feelings about parents

who have harmed or rejected them, and settle for permanence in

another family?

Can they find a way to identify with and ‘belong’ to both

families?

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Children who felt they ‘belonged’ to the foster family and

thought it would be a ‘family for life:

Could reconcile belonging to two families OR

Were physically and/or emotionally distanced from parents

Contact with parents relatively unproblematic (or no contact)

Where negotiating the boundaries between the two families

was difficult for children:

They were often ambivalent about parents and/or

Pre-occupied with unreliable, rejecting or dangerous parents

More difficult for these children to identify with foster family

and feel emotionally secure

Were more troubled about where they belonged

Foster care can provide stability, but often fails to do so

For 1/3 of children, placements broke down even after 3 years

But where foster care is stable

chance of positive outcomes similar for fostering & adoption

Need to avoid delay in admission and permanent placement

Late admission to accommodation may mean lengthy exposure to abuse/neglect other adversities

increases risk of placement instability and poor mental health

reduces chance of adoption

High levels of need for many fostered and adopted children

continuing support needed to ensure stability and child wellbeing

Important to help children in long-term foster placements make sense of their location between two families

support their sense of belonging to their foster families (as well as to their birth families).

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A collaboration between University of Stirling (Dr Helen

Whincup and others), University of York and AFAS (Dr

Margaret Grant)

Builds on Belonging and Permanence study, but in

Scottish context

Investigating decision-making, permanence, progress,

outcomes and belonging for children in Scotland placed

permanently away from their birth parents

October 2014 – October 2018

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Following up large sample of children who were under 5 years old

when accommodated (during the year 2012-13)

Pathways study: pathways over 4 years for all 1,836 children under 5

who became accommodated or looked after at home in 2012-13

Analysis of data from CLAS and SCRA (all local authorities)

Outcomes study: Histories, decision-making and outcomes for 416

adopted or fostered children, 3-4 years after accommodated

surveys of social workers and foster carers/adoptive parents (19

local authorities)

Qualitative study of children in 16 adoptive or foster families

Interviews with adopters, foster carers and some children

Policy and decision-making study

Interviews and focus groups with children’s and family placement

SWs, CHS panel chairs/members and others (9 authorities)

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Findings will be presented at

conference in Stirling on

September 19th 2018

Please join us!

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Nina Biehal, Sarah Ellison, Claire Baker and Ian Sinclair (2010)

Belonging and Permanence. Outcomes in Long-term Foster Care and

Adoption. London: BAAF.

Nina Biehal (2014) A sense of belonging: meanings of family and home

in long-term foster care, British Journal of Social Work, 44, pp. 955-971.

Nina Biehal, Ian Sinclair and Jim Wade (2014) Reunifying abused or

neglected children: decision-making and outcomes, Child Abuse and

Neglect, 49, pp.107-118

Jim Wade, Nina Biehal, Nicola Farrelly and Ian Sinclair (2011) Caring for

Abused and Neglected Children. Making the right decisions for

reunification or long-term care, London: Jessica Kingsley Publishers

Ian Sinclair, Claire Baker, Kate Wilson & Ian Gibbs (2005) Foster

Children. Where They Go and How They Get On. London: JKP.

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Poster sessionMake your way to the poster

number on your badge.

Once the presentation is finished, move in a clockwise direction to the next poster.

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The legislative landscape

Donald HendersonHead of Care, Protection and Justice

Scottish Government

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Reflections

on morning

Michael ChalmersDirector of Children and Families

Scottish Government

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Round table discussion

1. What do you think is working well with PACE?

2. What would be even better if… ?

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Poster session

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Poster sessionMake your way to the next

poster from the last session.

Once the presentation is finished, move in a clockwise direction to the next poster.

Round table discussion

1. What do you think is working well, in meaningfully involving children and their families – or carers – in providing services in your area of work?

2. What would be even better if… ?

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Closing comments

Michael ChalmersDirector of Children and Families

Scottish Government

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