Alan Rushton

Contact between Children Placed Away from Home and their Birth Parents: Research Issues and Evidence

The importance of maintaining contact between children temporarily or permanently looked after away from their birth parents is now believed to be so important to their psychosocial development as to be written into the Children Act. This position has been argued both on the basis of the rights of children and birth parents and on the claimed strength of the research evidence concerning the positive effects of contact and the negative consequences of its absence. The quality of the research evidence is reviewed. It is concluded that evidence on either the beneficial or adverse effects of contact is not strong and that the design and/or analysis of existing studies contain a number of weaknesses that preclude clear research-based guidance to practitioners.

A Scoping and Scanning Review of Research on the Adoption of Children Placed from Public Care

The aim of this review is to map the literature on the adoption of children from public care, to identify the extent of research-based knowledge and to note gaps in the evidence. Adoption research has grown over the last 40 years but, as the methodological quality has increased, so has the complexity of the questions to be answered. This review covers research on the problem profiles of placed children and the challenges to new parents, matching and preparation, contact arrangements, medium and long-term outcomes and interventions with adoptions in difficulty. The article recommends that adoption research needs to be considered as an integral part of general research into placement choices for children. Looking to the future, the commissioning of large-scale studies is recommended to gain a lifelong perspective on adoption, to identify predictors of outcome, the consequences of contact arrangements for all the parties, and the cost-effectiveness of different types of adoption support. Many smaller scale studies need to be commissioned to monitor the progress of the various policy initiatives and legislative changes designed to increase the use of adoption as a placement choice in the UK.

Parenting Late-Placed Children: The Development of New Relationships and the Challenge of Behavioural Problems

This article reports on the development of new relationships and the presence of behavioural and emotional problems in a study of 61 five- to nine-year-old children placed from care with the intention of permanence in new, unrelated families during middle childhood. When interviewed, new parents reported that 73% of the children had formed an attached relationship with one or both parents by the end of their first year in placement. The children who were not regarded as attached showed more behavioural and emotional problems and overactive/restless behaviour, and were also more likely to have been actively rejected by their birth parents. More detailed aspects of possible difficulties in the new parent/child relationships were investigated by means of a parent-completed questionnaire which explored the children’s expression of feelings. The non-attached children had many more difficulties in communicating their feelings and in specific interactions with their new parents by the end of the first year of placement. The new parents of these children tended to find it difficult to relate to them in a warm, responsive manner early in the placement and this worsened by the end of the year. There was considerable overlap between behavioural and relationship problems, suggesting the need to promote the quality of the relationship between children and their new parents as well as to reduce the level of behavioural problems in the children. Implications for post-placement support and intervention are discussed.

Contact between Children Placed Away from Home and their Birth Parents: Ryburn’s ‘Reanalysis’ Analysed:

Ryburn has critically reviewed our article on the research issues in the study of contact between children placed away from home and their birth parents (Quinton, Rushton, Dance, & Mayes, 1997). We argue that Ryburn seriously misrepresented our position. He also presented a ‘reanalysis’ of the studies we discussed, supplemented with references to other studies that we did not quote, which aimed to show that our conclusions were wrong. In this article we respond to Ryburn’s critique and raise questions concerning his interpretation of data and methods of reviewing that suggest that his conclusions from the research are unreliable.

Enhancing adoptive parenting: A randomized controlled trial

The aim was to conduct a pragmatic randomized controlled trial (RCT) to evaluate two parenting programmes designed for adopters of children late placed from care. Adoptive parents, with children between 3 and 8 years who were screened to have serious behavioural problems early in the placement, participated in home-based, manualized, parenting programmes delivered by trained and supervised family social workers. The adopters who agreed to join the study were randomly allocated to one of two parenting interventions or to a “services as usual” group. Baseline, immediate post-intervention and six-month follow-ups were assessed using questionnaires and adopter interviews. No cases were lost to follow-up at any point and satisfaction was high with both parenting interventions. At the six-month follow-up, a significant difference (p < 0.007) was found for “satisfaction with parenting” in favour of the intervention group (Effect Size d = 0.7). Negative parenting approaches were reduced in the intervention group. However, no significant differences in child problems were found between the intervention groups and control group, adjusting for baseline scores. Costs analysis showed that a relatively modest investment in post-adoption support would be well spent in improving adopters’ satisfaction with parenting in the intervention group compared to the routine service group.

Support for adoptive families: a review of current evidence on problems, needs and effectiveness

This review of research literature is concerned with selected aspects of adoption support, namely the problems for the placed children, the characteristics of the new families, the needs of both children and parents for services and what is known about the effectiveness of interventions for placements in difficulty. Alan Rushton identifies the most useful findings and considers their relevance for providing a modernised adoption support service. He concludes that knowledge is accumulating in many areas although more evaluative research needs to be conducted on promising interventions.

Findings from a UK Based Study of Late Permanent Placements

ABSTRACT This prospective, UK based adoption study examined the first year of placement of 61 boys and girls who joined permanent unrelated families during middle childhood. Most of the children had experienced abuse, neglect and discontinuity in their lives prior to this placement. The psycho-social functioning of the children and the development of family relationships were assessed by means of in-depth interviews with the new parents. High levels of behaviour problems were found in the children initially. About a third of the children showed a diminution of problems after placement, the remainder showed little change or a deterioration. At the end of the first year, 72% of the surviving placements were considered stable. An active rejection by birth parents stood out as a particular risk to placement stability, especially when accompanied by over active behaviour and where new parents had difficulty in maintaining warmth and sensitivity in their responses to the child in the early months of placement.

Joining a new family The views and experiences of young people placed with permanent families during middle childhood

Cherilyn Dance and Alan Rushton report on the views of a group of young people who had joined adoptive or foster families some six years previously when they were between five and 11 years old (the Maudsley Follow-Up Study). The report focuses on the experience of joining a new family, family relationships and feelings of belonging. It was striking that it could take some young people a considerable length of time to feel settled; however, by the follow-up stage the great majority felt very much a part of their family. Several described their placement as an opportunity for a ‘new start’. A small minority was less settled and expressed continued discomfort with their adoptive status. The authors discuss the direction of current practice and policy developments with reference to these findings.

Adopters' Experiences of Preparation to Parent Children with Serious Difficulties:

A selected group of adopters coping with very troubled children recently placed from care was asked about their satisfactions and dissatisfactions with the preparation for parenting that had been provided. Although some aspects were well received, most thought that the preparation had not been helpful in developing the parenting skills for managing difficult behaviour. It was notable that the childs level of disturbance still came as a surprise to many. The study, reported here by Alan Rushton and Elizabeth Monck, throws up the question of how to deliver a service that meets the need for both general preparation to adopt and preparation to parent the specific child eventually placed. Fresh consideration needs to be given to the best means, and timing, of parenting preparation and support.

Negative parental treatment of the singled-out child : Responses to the problem by health visitors, social services departments and child and adolescent mental health services

The focus of this three-part study was on the recognition of, and service response to, families in which negative or rejecting behaviour is shown towards one of the children, whereas the siblings are accepted. Part 1 was an interview-based survey of health visitors’ views. They were able to identify families with such problems but were seldom in a position to intervene constructively and referrals to specialist services were not easily achieved. Part 2 was a case file study based on referrals of alleged emotional abuse to social services offices. The nature of the risk-assessment process undertaken by social workers was explored and it was shown that, beyond the initial stage of seeing the families, a lack of capacity was evident to provide structured assessments of the child, formal assessment of parenting and observation of the parent-child relationship. One-third of the emotional abuse cases were subject to child protection registration but only a minority received substantial social work intervention. Although it was found that singly rather than jointly referred children were given less priority and had less-thorough assessments, this could have been related to other characteristics of these children. Part 3 explored how child mental health professionals conceptualized the families’ difficulties, devised therapeutic interventions, considered obstacles to engaging the families and assessed the benefit of psychological help. It was acknowledged that some of these families can present a considerable challenge to any child welfare system because of denial of the problem or difficulties in engaging with existing services. More attention needs to be paid in these cases to maternal mental health problems, especially depression. Recommendations are made for developing more accessible preventive services while ensuring the protection and effective treatment of the singled-out child.