Care Pathways and Outcomes Study

1. Care Pathways and Outcomes Study Dr Dominic McSherry Senior Research Fellow Institute of Child Care Research School of Sociology, Social Policy and Social Work Queen’s University Belfast RAFT permanence seminar Waterfoot Hotel Derry 17th September 2013

2. Care Pathways and Outcomes Study • Research team: Dominic McSherry, Montserrat Fargas Malet, Kerrylee Weatherall, and Greg Kelly • What is it about? Longitudinal study that examines placement patterns for a population of children (n=374) under 5 years old and in care in Northern Ireland on the 31st March 2000. It explores how the children & their parents/carers get on within different types of placement – Key question, does care placement matter? • Location: Institute of Child Care Research, School of Sociology, Social Policy and Social Work, Queen's University, Belfast • Funded by: The HSC Development Division of the Public Health Agency • Book publisher: British Association for Adoption and Fostering (BAAF)

3. Phase 3 Care Pathways and Outcomes: The Children’s Perspective (2006-2010) • Interviewed sub-groups of children and their parents/carers • 77 children: 18 adopted; 19 long-term stable foster care; 13 long-term stable kinship care; 15 on Residence Order; and 12 with birth parents • Profile of children interviewed:

4. Findings • Placement stability • Attachment • Self-esteem and happiness • Behaviour • Education • Parental/carer stress • Social services involvement

5. Placement Stability

6. Children’s attachments to their parents/carers IPPA-R results

7. Children’s self-esteem and happiness Piers-Harris self-concept scale

8. Children’s health and behaviour • Who had behavioural difficulties according to SDQ?

9. Children’s health and behaviour (contd.) • Which children had serious health problems according to parents/carers: • 1/11 in kinship care (9%) • 5/15 in foster care (33%) • 6/15 on Residence Order (40%) • 5/12 with birth parents (42%) • 11/18 Adopted (61%) • Children had a range of conditions, BUT these most prevalent in the adoption group, e.g. 8 diagnoses of FAS in total (n=77), with 5 of these in the adopted group. • The majority believed that child’s behaviour had stayed the same or improved. • Many parents/carers highlighted the strengths of children and positive behaviours.

10. Children’s education • The majority of children had poor scores in the BPVS • The majority of children adopted by previous foster carers and nearly half of those in foster care were receiving some additional supports at school. Most children living with birth parents were not receiving supports, despite needing it most. • The majority of parents/carers believed children were coping very well/ “alright” at school (considering their limitations), a few identified problems (e.g. bullying and behavioural problems). • A few children appeared to do very well at school and had passed the Eleven Plus test – but low expectations from teachers and social services.

11. Parent/carer stress PSI/SF results

12. Social Service Involvement • Birth parents were the most critical of the support provided by social services (feeling marginalised, undermined and distrusted by social services). • Some adoptive parents advocated for a continued role of social services; while others in addition to some RO carers felt a sense of ‘abandonment’ by social services post-adoption/post-Residence Order. • A few kinship carers experienced a sense of disregard and lack of support, and felt less valued/supported by social services precisely because they were relatives. • Some Residence Order carers were happy that social services were no longer there, leading ‘normal’ family lives; others advocated a continued role for social services, in terms of the provision of financial support. • Most kinship carers were happy with the support being provided by social services.

13. Summary • Placements characterised by stability, not much evidence of instability, BUT mostly entering teenage years – What happens next is critical • All long-term placements have the potential to nurture positive outcomes for children in terms of their attachment to parents/carers and self-concept • Highlights the importance of speaking to children • Children perspective, most securely attached and happy • Parental/carer perspective, higher level of problem behaviours and clinical stress for foster carers and birth parents • Significant health problems most prevalent in adoption • In educational terms, those with greatest need, i.e. children living with birth parents, received least amount of support

14. Care Pathways and Outcomes Study Thank You! McSherry, D., Fargas Malet, M. and Weatherall, K. (2013). Comparing long-term placements for young children in care: The care pathways and outcomes study – Northern Ireland. London: British Association for Adoption and Fostering (BAAF).