Harriet Ward

Emotional and Behavioural Difficulties of Children and Young People at Entry into Care

Emotional and behavioural difficulties of a sample of children and young people were identified at the point of entry to local authority care by analysis of social work case files. The files indicated high levels of need, including that in children aged under 5. Bedwetting was identified as an important issue related to the physical health and emotional well-being of looked-after children. There was an association between bedwetting and emotional and behavioural problems. Analysis of placement types at entry to care showed that significantly more boys than girls were first placed in residential care.

The best of times, the worst of times: young people's views of care and accommodation

There is much evidence of instability in the care system and poor developmental outcomes for looked after children, but looked after children are far from being a homogenous group. Their lives, needs and experiences vary immensely. Harriet Ward, Tricia Skuse and Emily R Munro present the findings from a recent study of childrens views of the care system in England (Skuse and Ward, 2003). They explore what children and young people did and did not like about being looked after, why some found it a beneficial experience while others did not, and discuss the reasons for their largely positive responses. Ordinary features of everyday life that peers would usually take for granted, such as having someone to talk to or doing ordinary family things like going to the cinema, were identified as benefits of the care system. These views and the expectations of looked after children need to be considered in the context of their past life experiences.

An Analysis of Offending by Young People Looked After by Local Authorities

The association between local authority care and offending behaviour was examined in 250 looked after young people of the age of criminal responsibility. Whilst a greater number of the young people had committed offences than in the general population, the vast majority were law abiding. For those who did offend, the care episode itself was unlikely to have been the sole cause of their delinquency. The findings suggest that the services offered once the young people entered local authority care did not succeed in combating established offending behaviour. Perhaps initiatives targeted in the community prior to entry to care may be more effective.

Issues concerning the health of looked after children

There is substantial evidence that looked after children have extensive health needs and disabilities, that they have often missed out on routine health surveillance and health promotion before entry to care or accommodation, but that at present they receive little compensatory care. Harriet Ward, Helen Jones, Margaret Lynch and Tricia Skuse discuss these issues. They look at how frequent changes of placement and poor inter-agency communication exacerbate difficulties in gaining access to adequate health care, especially when children lack an advocate who takes proactive action on their behalf. The Department of Health has responded by issuing new Guidance that sets clear standards for service delivery, encourages childrens participation, and ensures that health assessments recognise inequalities and take a holistic view of healthcare needs. The implementation of the Integrated Childrens System should improve the quality and accuracy of health information concerning all children in need. New Regulations and Standards for foster care, a National Healthy Care Standard and, on a broader policy front, the National Service Framework for Children should all ensure better access to health care for this population. However, as the authors conclude, such measures will only be successful if inter-agency working can be improved through multi-disciplinary training and better co-ordinated structures for service delivery.

A Strategy for Assessing Costs of Implementing New Practices in the Child Welfare System: Adapting the English Cost Calculator in the United States

In decisions to adopt and implement new practices or innovations in child welfare, costs are often a bottom-line consideration. The cost calculator, a method developed in England that can be used to calculate unit costs of core case work activities and associated administrative costs, is described as a potentially helpful tool for assisting child welfare administrators to evaluate the costs of current practices relative to their outcomes and could impact decisions about whether to implement new practices. The process by which the cost calculator is being adapted for use in US child welfare systems in two states is described and an illustration of using the method to compare two intervention approaches is provided.

Looking for long-term outcomes: what early interventions are needed for children and young people at risk of maltreatment in England?

The Safeguarding Children Research Initiative (Davies & Ward, 2012) was a programme of fifteen studies commissioned by the Department of Health and what is now the Department for Education, each of which explored a different aspect of safeguarding children. This paper brings together the findings of these studies to explore the types of strategies that have been shown to promote positive long-term outcomes for children and young people at risk of maltreatment. The authors ighlight the potential harm caused to children when they are exposed to maltreatment and demonstrate the range of interventions that have been developed to improve their long-term outcomes. The paper provides examples of universal, targeted and intensive services with a strong evidence base for success. The most effective intensive interventions are found to be those that prevent the occurrence or re-occurrence of altreatment, address the underlying factors associated with maltreatment and the various stages associated with the process of change. The authors also examine the supplementary issues practitioners need to be aware of when considering the choice of intervention, including some of the obstacles to providing support, such as the nature of the evidence base, the extent to which different agencies work together to provide services for vulnerable children and families, the availability of resources and the ways in which children and families move between different parts of the child welfare system. If practitioners are to make best use of the available interventions, it is important that they select those underpinned by robust evidence showing that positive outcomes have been achieved for families in similar circumstances