Assessing the Support Needs of Adopted Children and Their Families

Building Secure New Lives

Liza Bingley Miller, Arnon Bentovim

• Publisher: Routledge
• Year: 2006
• eBook ISBN: 9781134131143
• Topic: Medicine
• Subtopic: Health Care Delivery

Written in consultation with a range of experts, clinicians and practitioners as well as adoptive children, families and birth relatives, this book gives helpful guidance on making evidence-based assessments and planning successful adoption support. Key features include:

• a discussion of the main themes of adoption and pointers for practice in relation to the Assessment Framework
• a guide to the use of evidence-based approaches to assessment, including the tools commissioned by the Department of Health and the Department for Education
• a model for analysis and planning, and planning support and interventions
• an investigation of the source, range and value of support services and interventions that can promote the wellbeing of adopted children, their adoptive families and birth relatives.

Packed with practical advice, case examples and models of good practice, this book is invaluable for social workers and managers involved with the adoption process and the well-being of children and families. It is also essential reading for social work students learning about working with children and families.

Chapter 1
The children

Characteristics of children placed for adoption and their families

The profile of children who are being adopted has changed over recent years; children are now increasingly adopted at an older age, often with some form of contact with members of their birth family (Rushton 2003b; Scott and Lindsey 2003). They are likely to have been looked after within the care system, undergone several moves of placement once they have left their birth family and may have established close ties with foster carers whom they have to leave to join their adoptive family. The ethnic and cultural backgrounds of children being adopted is now much more diverse, and black and minority ethnic children may not be placed with a family of a similar background.

Nearly half (47 per cent) of children between 0 and 17 years old placed from the looked after system for adoption have mental health difficulties, developmental delay, special needs arising from a physical or learning disability or an identified health condition (McCarthy et al. 2003; Meltzer et al. 2000). Most have experienced care that has been inadequate to meet their needs, often from an early age, and many have experienced abuse or neglect or other traumatic experiences (Cleaver et al. 1999). Black and minority ethnic children are likely to have particular needs relating to their racial and cultural heritage and identity (Harris 2003). Children who have been with carers from a different racial or cultural background in earlier placements, or in their permanent placement are likely to have extra support needs, as will with the families who care for them.

Over 15 per cent of adoptions are by foster carers who become the adoptive parents of children they have fostered from the care system (Argent 2003b) these placements have a comparatively high success rate. In view of the history of their relationship with the children they adopt, these foster carers need to understand their shifting role, help the children to understand adoption and negotiate the change of status with the child’s birth family where relevant (Ivaldi 2000; Lowe and Murch 2002). Issues related to contact and relationships with a child’s birth family may change because of the previous relationship, which may have included a plan for rehabilitation which has not been successful.

Foster carers already have a relationship with the local authority, which also changes when they become adoptive parents. They will already, in partnership with the local authority, be meeting specific needs of the child placed with them, and this needs to be carried forward into the adoption. This will be different from the situation for adoptive parents who are new to the child and birth family.

Birth parents or other birth relatives will often have significant difficulties of their own, which may include psychiatric problems, drug or alcohol misuse or a pattern of domestic violence in the family home. The impact of these difficulties will be reflected in the developmental needs of the child, and may have implications for contact arrangements.

Table 1.1 gives a profile of adopted children in England in 2003.

Potential profile of special guardians and the children they care for

Special guardianship is intended to meet the needs of children for whom adoption is not appropriate, but who cannot return to their birth parents and could benefit from the permanence provided by a legally secure arrangement with their carer. For example, some older children (who may, for instance, be looked after in longterm foster placements) do not wish to be adopted and have their legal relationship with their parents severed, but could benefit from greater security and permanence.

For detailed information on the new special guardianship arrangement, readers should refer to the accompanying Guidance to the Special Guardianship Regulations 2005. The information below is a summary only.

Adoption may also not be the best option for some children being cared for on a permanent basis by members of their wider family. Some ethnic minority communities have religious or cultural difficulties with adoption in the form provided for in England and Wales (Rashid 2000), and may wish to use special guardianship, especially given the higher proportion of black children living in kinship care arrangements (Broad 2001). Special guardianship may also be a helpful option for the increasing numbers of refugee or asylum seeking children who are in desperate need of care and permanence but who may have strong ties with their birth families.

Special guardianship is a welcome route to providing a greater degree of permanence for a group of children and young people with complex needs who are being cared for outside their immediate birth family. It recognises that the children and families involved will need support.

Special guardians are likely come from a range of carers, including members of a child’s wider birth family, for example grandparents and foster carers. Many special guardians may be caring for children who have ongoing significant relationships and contact with their birth parents. The children are likely to be older than many adopted children, and they may have been in the looked after system for some time. They may present with behaviour that is challenging or have significant levels of physical or learning impairments, emotional disturbance or psychiatric disorder. The children may have been emotionally abused or neglected in the past and have associated attachment difficulties.

Foster carers may differ from others who become special guardians because they will have already worked alongside other professionals, and will have a relationship with the child, knowledge of the child’s history and an understanding of the role of the local authority and the child’s social worker in the child’s life. They also have experience of the child’s needs and services already being provided to meet them (Broad and Skinner 2005; Ward 2004).

Table 1.1 Profile of adopted children in England for the year ending 31 March 2003

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Looked after children

• 60,800 children were in the care of local authorities on 31 March 2003
• 24,600 children started to be looked after during the year ending 31 March 2002
• 25,100 children ceased to be looked after during the year ending 31 March 2002

Gender

• 55 per cent of children looked after on 31 March 2003 were boys and 45 per cent were girls

Age

• 4 per cent of children looked after on 31 March 2003 were under 1 year old
• 15 per cent were aged between 1 and 4 years old
• 22 per cent were aged between 5 and 9 years old
• 43 per cent were aged between 10 and 15 years old
• 16 per cent were aged 16 and over

Ethnicity

• 81 per cent of children looked after on 31 March 2003 were white and 19 per cent were from black and minority ethnic backgrounds

Placements

• 10 per cent of children looked after on 31 March 2003 were living in children’s homes
• 10 per cent were living with their parents
• 6 per cent were placed for adoption
• 68 per cent were living with foster carers
• 7 per cent were in other placements such as residential schools, lodgings and other residential settings

Unaccompanied asylum seeking children

• 2,480 unaccompanied asylum seeking children were looked after on 31 March 2003
• 76.6 per cent were boys and 23.4 per cent were girls

Adoption

• 5,680 adoption orders were made in England and Wales during 2002
• 3,500 children were adopted from care during the year ending 31 March 2003
• 540 children were adopted by their foster carers during the year ending 31 March 2003

Gender

• 53 per cent of children adopted during the year ending 31 March 2003 were boys and 47 per cent were girls

Age

• 7 per cent of children adopted during the year ending 31 March 2003 were under 1 year old
• 59 per cent were aged between 1 and 4 years old
• 29 per cent were aged between 5 and 9 years old
• 5 per cent were aged between 10 and 15 years old
• 0 per cent were aged 16 and over
• The average age at adoption was 4 years 3 months

Duration

For children adopted during the year ending 31 March 2003:

• The average time between entry into care and adoption was 2 years 9 months
• The average time between the best interest decision and adoption was I year 8 months

Adoption Search and Reunion: The Adoption Contact Register for England and Wales

At 30 June 2001, there were 19,683 adoptees and 8,492 relatives on the Adoption Register for England and Wales, and 539 successful matches have been made since the start of the Adoption Register in 1991.

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Source: DfES 2003b, 2003c.

The children cared for by special guardians are likely to have many similarities with adopted children, though there may be differences, for example in relation to identity issues and contact.

Terminology in this book

We have used the term support services to cover collectively both the adoption and special guardianship services as described in the Regulations and wider children and family support services, as unless otherwise stated. When we refer to support needs and support services, this relates to needs and services that could apply equally to adoptive families and special guardianship families. Where a distinction is necessary between these two permanence options, it will be highlighted. Adopted children and children cared for by special guardians are generally referred to as adopted children, adoptive parents and special guardians are referred to as adoptive parents, except again where it is necessary to be more specific because of special issues relating to each group. While special guardians and adoptive parents are both undertaking the parenting task in a caregiving or parenting role, it is appreciated that many children cared for by special guardians may not either call or view their special guardians as their ‘parents’. References to birth relatives are always clearly identified.

The book uses the term adoptive family to describe the family environment in which the adopted child is being brought up. This is intended to cover the wide range of family arrangements which may be involved when children live with a single parent, two parent families, families with or without birth children and families who live in a wider family group.

Key themes in adoption and special guardianship – a summary

Caring for children as adoptive parents or special guardians differs from bringing up birth children in important respects and assessments should take full account of these differences. Some key themes to keep in mind are discussed in detail in Chapters 5, 6 and 7. They are summarised here:

• Valuing adoptive parents: Adopters and special guardians should be valued and respected as fulfilling an important role in providing acceptance, good parenting and a lifelong commitment for children with high levels of need and should be approached as partners in assessing support needs.
• A developmental and lifespan approach to adoption: Adoption is for life can be viewed as a developmental and lifespan process for all parties in the adoption triangle – adopted children, adoptive families and birth families. Assessments should take into account the stage that the adoption process has reached and the implications for support that may help those concerned.
• Support needs of children, birth families and adoptive families: Taking a holistic view of the support needs of all members of the adoption triangle (the adopted child, their birth family and their adoptive family) is likely to promote the welfare and wellbeing of the child.
• The impact of stressful past events and relationships in the birth family context: The heritage, experiences and memories that an adopted child imports into their adoptive family has a significant impact on the adoptive family. A child may bring happy memories of times they have enjoyed in their birth families and warm relationships which have been important to them, for example with kind grandparents, or in their foster families. The developmental needs of many adopted children are also affected by earlier experiences of inadequate parenting, including abuse and neglect, domestic violence and other traumatic events. This can result in physical and psychological health problems which tend persist over many years and well into the child’s life with the adoptive family (DoH 2002b).
• Attachment: All adopted children have experienced separations and loss, which affects their development. Early experiences of separations and loss and adverse relationships with significant parents/caregivers and inadequate caregiving can seriously affect children’s capacity to become attached and relate to others. Some may continue to have significant difficulties all their lives.
• Loss: Loss is a theme common to all members of the ‘adoption triangle’. Birth family members often have a profound sense of loss. Adopted children experience a range of losses and many adoptive families have experienced losses, including those associated with infertility.
• The child’s identity and heritage: A major task for adopted children is to develop a sense of their identity which incorporates their history with their birth family, including their racial, linguistic, spiritual and cultural heritage. The experience of being adopted on identity and on genealogical continuity needs to be considered when assessing support needs (Owusu-Bempah and Howitt 1997).
• Challenges in parenting adopted children: Parenting adopted children has rewards and considerable challenges when adopted children have high levels of need as a result of earlier adverse experiences. Adoptive parents need additional or enhanced parenting skills, and support at times, to be able to respond to the additional needs of adopted children. Interventions may range from information or advice, practical help, training, contact with other adoptive parents, specialist therapeutic help or a multi-agency support package.
• Contact with the child’s birth family: Continuity and contact with birth relatives can be of great value to adopted children (Macaskill 2002; Neil 2002). Contact can also present significant difficulties for children and adoptive parents and birth relatives. Support may be required to ensure contact arrangements are in the best interests of the adopted child.
• Developing ‘adoption aware’ services: Adopted children have contact with a wide range of services including health, education and social services and professionals in those services should be ‘adoption aware’, i.e. have an understanding of adoption and its impact on the support adopted children and families need.

Chapter 2
The legal and policy context and when to assess

The legal context

The Adoption and Children Act 2002 (the 2002 Act) requires each local authority to maintain an adoption service, which must include arrangements for the provision of support services. Section 4 of the Act contains the specific duties and powers to assess and provide adoption support, but most of the detail can be found in the Adoption Support Services Regulations 2005 and Chapter 9 of the Adoption Guidance 2005.

The 2002 Act’s regime for adoption support was implemented in two phases, the first of which came into force late in 2003. The 2005 Regulations implement the second and final phase. The provisions of...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Acknowledgements
• Introduction
• Chapter 1: The children
• Chapter 2: The legal and policy context and when to assess
• Chapter 3: Using the Assessment Framework model
• Chapter 4: Understanding the needs: Key themes
• Chapter 5: Assessing adopted children’s developmental needs using the Assessment Framework
• Chapter 6: Assessing adoptive parenting capacity using the Assessment Framework
• Chapter 7: Assessing family and environmental factors using the Assessment Framework
• Chapter 8: Responding to needs
• Annex 1: Chart of information gathered by use of evidence-based assessment tools in assessing adoption support needs using domains and dimensions of the Assessment Framework
• Bibliography