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Assessing Children in Need and their Families:

Practice Guidance

 

Department of Health

Assessing Children

in Need and their

Families:

Practice Guidance

London

The Stationery Office

Social Care Group

The Social Care Group is one of the four business groups in the Department of Health. It

is jointly headed by the Chief Social Services Inspector and the Head of Social Care Policy.

It supports Ministers in promoting high quality, cost effective services through

_ national policies

_ support to external social care agencies

_ inspection

The Social Services Inspectorate is a part of the Social Care Group. It is headed by the

Chief Social Services Inspector who is the principal professional advisor to Ministers on

social services and related matters.

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© Crown copyright 2000

First published 2000

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Foreword ix

Introduction xi

1 Knowledge underpinning the Assessment Framework 1

Wendy Rose and Jane Aldgate

1.1 What is meant by knowledge in this chapter 1

1.4 Child development 1

1.8 The importance of attachment 4

1.14 Protective factors and resilience 5

1.19 Children’s perspectives 8

1.20 Parental capacity 9

1.32 Parents’ perspectives 12

1.35 Theories and myths of the individual in society 12

1.38 Wider family, community and environmental factors 13

1.49 Overarching theories and approaches that inform practice 16

1.55 Methods of intervention 17

1.56 Roles and tasks of child and family workers 19

1.62 The challenge of evidence based work 20

Appendix 1 Chart illustrating the developmental progress of infants and 23

young children

Appendix 2 Genogram 29

Appendix 3 Ecomap 30

References 31

2 Assessing black children in need and their families 37

Ratna Dutt OBE and Melanie Phillips

2.1 Introduction 37

2.8 Assessing black children in need and their families 37

v

Contents

2.13 Demography 38

2.17 Socio economic conditions 39

2.19 The changing nature of culture for England’s black population 39

Key issues in current child welfare practice 40

2.23 Numbers of black children in care 40

2.25 Family Support 40

2.26 Inquiry Reports 40

THEORIES AND PRACTICE INFORMING ASSESSMENT 41

Domain: Children’s Developmental Needs 41

2.28 Health 41

2.29 Education 42

2.31 Identity and Emotional and Behavioural Development 43

2.33 The nature of Identity 43

2.35 Group identification 43

2.37 Individual and personal identity 43

2.42 The development of a racial identity 44

2.53 Ethnicity 47

2.57 Cultural, religious and linguistic identity 47

2.59 Culture 48

2.60 The aquisition of cultural identity 48

2.67 Religion 49

2.71 Language 50

2.76 Social Presentation and Selfcare Skills 50

2.80 Family and Social Relationships 51

Domain: Parenting Capacity 54

2.95 Basic Care 54

2.96 Ensuring Safety 54

2.112 Racial abuse and harassment 57

2.119 Emotional Warmth 58

2.129 Stimulation 60

2.133 Guidance, Boundaries and Stability 60

Domain: Family and Environmental Factors 62

Family History and Functioning 62

2.143 Family size 62

2.146 Family structure and arrangements 63

2.149 Parenting strengths and difficulties 64

2.152 Wider Family 65

2.156 Housing 65

2.158 Employment 66

vi

2.160 Income 66

2.165 Families Social Integration 67

2.166 Community Resources 68

References 70

3 Assessing the needs of disabled children and their families 73

Ruth Marchant and Mary Jones

3.1 Introduction 73

3.6 Disabled children and the Assessment Framework 74

3.12 Disabled children and assessment 75

3.13 Using assessments positively with disabled children and young people 76

Domain: Child’s Developmental Needs 79

3.35 Health 80

3.43 Issues of consent 82

3.45 Basic health care 82

3.48 Education 83

3.54 Emotional and Behavioural Development 84

3.61 Identity 85

3.68 Family and Social Relationships 87

3.74 Social Presentation 88

3.76 Selfcare skills 89

3.79 Domain: Parenting Capacity 89

3.82 Basic Care 90

3.84 Emotional Warmth 91

3.85 Ensuring Safety 91

3.92 Stimulation 93

3.94 Guidance and Boundaries 93

3.99 Stability 94

Domain: Family and Environmental Factors 95

3.104 Family History and Functioning 96

3.107 Wider Family 96

3.111 Housing 97

3.117 Employment 98

3.120 Income 99

3.123 Family Social Integration 100

3.125 Community Resources 100

3.128 Involving children in the assessment process 101

3.139 Conclusion 103

Appendix 4 Definitions of Disability and Key Legislation 104

References 108

vii

4 Resources to assist effective assessment of children in need 113

4.1 Introduction 113

4.2 The collection and recording of information 113

4.5 Resources commissioned to assist the assessment process 114

4.6 Principles underpinning the use of practice materials 114

4.7 Assessment records 115

4.14 Use of questionnaires and scales in assessment 116

4.21 Evidence based publications 119

4.31 Training resources 122

References 127

viii

ix

This publication is a companion volume to the Guidance on the Framework for the

Assessment of Children in Need and their Families. It is a significant contribution to a

major programme of work led by the Department of Health to provide guidance,

practice materials and training resources on assessing children in need and their

families. This is to assist in the achievement of one of the government’s key policy

objectives in children’s services, delivered through the Quality Protects Programme,

to ensure that referral and assessment processes discriminate effectively between

different types and level of need, and produce a timely response.

Whilst government policy objectives may be clear, effective implementation requires

detailed knowledge and understanding. The practice guidance has been produced

to help policy makers, managers and practitioners who have responsibility for

responding to the needs of some of our most disadvantaged and vulnerable children.

The needs of some children require particular knowledge and sensitivity to ensure

they do not suffer further disadvantage. These include children from black and

minority ethnic families and disabled children. The issues involved in assessing their

needs within the context of their families and communities are discussed by leading

professionals in their field. The steering and advisory groups, which were set up to

develop the Guidance on the Assessment Framework, have contributed to these

perspectives.

It is hoped this publication will be a valuable resource for use in promoting evidencebased

practice, not only in direct work with children and families but also in training

and continuing staff development.

John Hutton

MINISTER OF STATE FOR SOCIAL SERVICES

March 2000

Foreword

 

xi

The body of knowledge available to those who struggle with today’s problems of

child care is still rudimentary compared with the physical sciences; but it is by far

and away greater than what could called upon in the past… Indeed, social work

today is expected to be ‘evidence-based’, something that would have been an

unrealistic aspiration in, say, the 1950s, when there was virtually no evidence upon

which to draw (Parker, 1999, pp.54–55).

Understanding what is happening to a child when there are concerns that the child’s

health and development are being impaired remains a core professional activity for

those working with children and families. The knowledge which is available to assist

them has expanded dramatically over the last two decades. However, it has not always

been easily available to practitioners and their managers. The development of the

Framework for the Assessment of Children in Need and their Families (jointly issued by

the Department of Health, the Department for Education and Employment and the

Home Office, 2000) has drawn heavily, from many disciplines, on the wealth of

research and accumulated practice experience about the developmental needs of

children. The aim of the practice guidance in this accompanying publication is to

make transparent the evidence base for the Assessment Framework, thereby assisting

professionals in their tasks of analysis, judgement and decision making.

Chapter 1 highlights some of the key theories, research findings and practice wisdom

which have underpinned the development of the Assessment Framework and in

which confidence can be placed. Staff who are working with children and families may

find further exploration of the texts referenced in this chapter helpful in informing

their practice. Chapter 2 provides more specific knowledge and guidance about

working with black children and their families and points to useful sources of

information. Chapter 3 similarly provides knowledge and guidance about assessing

the needs of disabled children and their families. These two chapters address issues of

major importance which must be integral to policy, planning, management and

practice in work with children and families. However, the messages which can be

drawn from these two chapters can be used in work with all children.

The Department of Health is grateful to the authors of the chapters:

Chapter 1: Wendy Rose, Senior Research Fellow and Jane Aldgate, Professor of

Social Care, The Open University

Introduction

Chapter 2: Ratna Dutt OBE, Director, REU and Melanie Phillips, Researcher,

Trainer and Consultant to REU

Chapter 3: Ruth Marchant and Mary Jones, Directors of Triangle

The concluding chapter, Chapter 4, outlines a significant package of Department of

Health commissioned resources which can be used to support staff in their practice

and in their professional development. These resources include texts summarising key

messages from relevant research findings, questionnaires and scales to assist work with

children and families, training materials and other work under development.

These are only a selection of what is available. Knowledge is continually being updated

and important developments will take place over the next few years. It is, therefore,

incumbent on all professionals involved in training, management and practice to be

continually alert to new resources, to ensure that work with children and families is

firmly evidence-based. Through the Department of Health’s Quality Protects

Programme, an important process of change is underway aimed at improving the

outcomes for children in need. The development of the Framework for the Assessment

of Children in Need and their Families and its associated materials forms a significant

part of this programme.

Jenny Gray

SOCIAL CARE GROUP

DEPARTMENT OF HEALTH

REFERENCES

Department of Health, Department for Education and Employment and Home Office (2000)

Framework for the Assessment of Children in Need and their Families. Stationery Office, London.

Holman B, Parker R and Utting W (1999) Reshaping Child Care Practice. NISW, London.

xii

What is meant by knowledge in this chapter

1.1 Throughout the Framework for the Assessment of Children in Need and their Families

(Department of Health et al, 2000) to which this practice guidance relates, it has been

emphasised that the framework is grounded in knowledge. Knowledge is defined as

theory, research findings and practice experience in which confidence can be placed to

assist in the gathering of information, its analysis and the choice of intervention in

formulating the child’s plan.

1.2 This chapter explores how theory, research and practice assist in understanding each of

the three domains or systems of the framework and their interaction, the roles and

tasks of the child and family worker, the processes of planning and decision making

and the importance of evidence based work.

1.3 There are many theories from a range of disciplines which contribute to the

understanding of human growth and development and the interaction between

internal and external factors which have an impact on the lives of individuals.

Schofield (1998, p.57) summarises the importance of the interplay of these factors

which can be applied to the Assessment Framework:

Social workers need a framework for understanding and helping children and

families which takes into account the inner world of the self and the outer world of

the environment, both in terms of relationships and in terms of practicalities such as

housing. It is the capacity of social workers to be aware of and integrate in their

practice these different areas of concern which defines the distinctive nature of their

professional identity.

In Chapter 2 of the Guidance on the Assessment Framework (Department of Health

et al, 2000), the three domains of child’s developmental needs, parenting capacity and

family and environmental factors are described (Figure 1). These domains and their

interrelationship take account of ‘the inner world of the self and the outer world of the

environment’ (Schofield, 1998).

Child development

1.4 It has long been recognised that children develop along several dimensions, often

simultaneously, and that they need to reach a series of milestones along each

dimension if optimal outcomes are to be achieved. It is acknowledged that there will

be differential development across the dimensions for some children, for instance,

1

1 Knowledge underpinning the Assessment

Framework

2

Health

Education

Emotional &

Behavioural

Development

Identity

Family & Social

Relationships

Social

Presentation

Selfcare Skills

Basic Care

Ensuring

Safety

Emotional

Warmth

Stimulation

Guidance

& Boundaries

Stability

CHILD

Safeguarding

and promoting

welfare

Family

History

& Functioning

Wider Family

Housing

Employment

Income

Family’s Social

Integration

Community

Resources

CHILD’S DEVELOPMENTAL NEEDS

PARENTING CAPACITY

FAMILY & ENVIRONMENTAL FACTORS

Figure 1 The Assessment Framework

those with impairments. Different aspects of development will have more or less

weight at different stages of a child’s life. For example, in the early years, there is an

emphasis on achieving physical milestones. Sheridan’s charts on development in the

early years, from one month to five years are a valuable source of reference here

(Appendix 1). In middle childhood, social and academic capacity becomes more

prominent although the physical development continues (for example Rushton et al,

1988), while the adolescent strives to reconcile social and emotional dependence and

independence (Department of Health, 1996). Some examples of developmental tasks

to be achieved at different stages are summarised by Masten and Coatsworth (1998) in

Figure 2.

Figure 2 Examples of Developmental Tasks

1.5 What happens to children in the first years of life is the foundation of later development

and will affect their outcomes. The significance of this must be taken into account in

the assessment process. This is why secure attachments are so important in the early

years. Where these attachments are absent or broken, decisions to provide children with

new attachment figures must be taken as quickly as possible to avoid developmental

damage. Careful distinction has to be drawn between delay which is harmful to a child’s

development and taking appropriate time to make good plans.

3

Age Period Task

Infancy to preschool Attachment to caregiver(s)

Language

Differentiation of self from environment

Self control & compliance

Middle childhood School adjustment (attendance, appropriate conduct)

Academic achievement (eg. learning to read, do

arithmetic)

Getting along with peers (acceptance, making friends)

Rule-governed conduct (following rules of society for

moral behaviour and prosocial conduct)

Adolescence Successful transition to secondary schooling

Academic achievement (learning skills needed for

higher education & work)

Involvement in extracurricular activities (eg. athletics,

clubs)

Forming close friendships within & across gender

Forming a cohesive sense of self-identity

Masten and Coatsworth (1998)

1.6 The seven dimensions along which children develop, discussed by Ward (Horwath

(ed) 2000), are influenced by many factors. Recent empirical research, for example,

has suggested connections between biological and other areas of development. The

development of the infant brain mirrors developmental experience in general. It is

argued by Perry (1993) that the brains of developing infants react to the quality and

nature of sensory information. For example, children raised with little or no

experience of verbal language may have difficulties in attaining the neurodevelopment

required for optimal speech or language. As the result of research

findings, Pugh (1999) makes the point strongly:

Environmental stress has a negative effect not only on how the brain develops, but

how it functions, and underlies our capacity to make and sustain relationships.

1.7 Additionally, as Schofield (1998) suggests, it is important to take account of the

psycho-social influences on children. Clare Winnicot described in the 1960s (quoted

by Schofield) how these influences relate to what takes place in children’s inner and

outer worlds.

The importance of attachment

1.8 Two major concepts critical to the interrelationship between the inner and outer

worlds are attachment and self esteem. As Schofield suggests, these are interactive.

One of the most influential writers on attachment has been John Bowlby whose work

is still highly relevant (1958; 1969; 1973; 1980). His work has been taken forward by

others such as Rutter, Ainsworth, Fahlberg, Jones and Howe. However, the process of

attachment is far from simple, as Crittenden and Ainsworth (1989, p.432) suggest:

Attachment theory is a relatively new, open-ended theory with eclectic

underpinning. … Although it began with an attempt to understand disturbed

functioning of individuals who had experienced traumatic losses or early

separations, it is a theory of normal development that offers explanations for some

types of atypical development (Bowlby, 1969; 1973; 1980).

Pugh (1999) argues that ‘attachment theory makes an important contribution to our

growing understanding of the importance of social and emotional competence as the

basis of self-esteem, and a key ingredient in the concept of resilience’ (which is

discussed later in this chapter).

1.9 Children who are securely attached to significant adults in early childhood have been

shown to be able to develop appropriate peer relationships, and cope well with

problems that confront them. It is also known that children who have had good

attachment experiences will be able to use these in their relationships with their own

children in later life. It is because of the importance of good attachment experiences

that practice concerned with helping children who have lost attachment figures places

so much emphasis on providing these children with continuity of good alternative

parenting experiences. Bentovim (1998) reminds practitioners that there is strong

association between significant harm and insecure attachments, citing Carlson et al

(1989) who found that more than 80% of significantly harmed infants had

disorganised attachments compared to less that 20% in a non-maltreated comparison

group.

4

1.10 The central place of attachment disturbance in cases of child maltreatment is also

noted by Jones et al (1999) and the relationship with parents’ own experiences:

Attachment difficulties are linked with parental childhood histories of abuse and

deprivation, parental personality difficulties, as well as functional illnesses such as

depression. The identification of parent/child attachment difficulties has

important implications for intervention, particularly in view of the outcome

literature in child maltreatment, where persisting parent/child attachment

difficulties combined with evidence of psychological maltreatment on follow-up is

a consistent finding (Jones, 1998).

1.11 The wealth of research on attachment reinforces the importance of paying attention to

attachment in assessments of all children, irrespective of their age. Teenagers who have

had poor attachment experiences in their early years are particularly vulnerable,

especially if they have experienced many separations and a childhood of discontinuity.

Teenagers are also vulnerable if they lose good attachments in their adolescent years.

Children who are joining new families, therefore, need special attention, as BAAF

(1999) suggests:

Many children will in time build positive healthy attachments in their new family,

integrate their past and present experiences, and enter adulthood with a sense of

stability and belonging. Yet the experience of adult adoptees reminds us that the

interruption of primary connections has consequences which are potentially

lifelong, and may result in a deep sense of personal loss and rejection.

1.12 Practitioners will need to integrate multi-faceted knowledge of child development

into their assessments and, in particular, what is relevant from psychodynamic theory

and learning theory (Seden, 2000). The development of children’s inner and outer

worlds can be understood within general principles of psychodynamic theory which

focuses on the importance of the psychological processes at work in three key

relationships: ‘between self and significant other people, past and present experience,

and inner and outer reality’ (Brearley, 1991, pp.49–50). These ideas are important in

understanding what is happening to a child.

1.13 Children’s cognitive, emotional and social development go hand in hand. Children’s

behaviour, both adaptive and maladaptive may be learned from their experiences.

Learning theory suggests behaviour that is learned can also be unlearned, with the

possibilities of maladaptive behaviours being replaced with positive, pro-social

behaviours. Key exponents include Skinner (1974) on operant learning, Bandura

(1977) on observational learning and Seligman (1975) on learned helplessness, and

Hudson (1991) among many others. Caution has to be exercised here. The results of

intervention will depend on the level and scope of children’s positive and negative

developmental experiences and other factors.

Protective factors and resilience

1.14 Not only are children’s experiences germane to their development but other factors

within individual children, such as temperament, personality and gender all influence

the way they are likely to react to experiences of their families and the environment in

which they are growing up. A number of writers have summarised the factors which

5

may protect children and those which may make them more vulnerable (Rutter in

Haggerty et al, 1996; Jones in Adcock and White (eds), 1998; Masten and

Coatsworth, 1998). An example (Table 1) is included in this chapter from Crossing

Bridges (Falkov (ed),1998, p.72).

1.15 Children vary widely in the way they may respond to a set of circumstances. Some

children may do well even in the most adverse circumstances while others appear to

have little capacity to cope with small amounts of stress. It is therefore important to

understand what may act as protective factors in children’s lives and what may be

stressors or vulnerabilities. Increasingly, interest is being shown in the concept of

resilience in children (discussed by Gilligan, 2000). Rutter (1999, pp.119–120)

describes resilience as:

The phenomenon of overcoming stress or adversity. That is, put in more

operational terms, there has been a relatively good outcome for someone despite

their experience of situations that have been shown to carry a major risk for the

development of psychopathology.

1.16 As with attachment, resilience is a broadly based concept of some complexity. This

means there must be a careful analysis which focuses not just on the individual or the

family but on ‘the relevant stresses and adversities in their social context’ (Rutter 1999,

p.159). The importance of taking a broadly based approach to the assessment of

children is highlighted by current ideas on protective factors. The evidence suggests

strongly that children vary considerably in their responses to positive and negative

experiences. Multiple protective and adverse factors may be involved at the same time.

Rutter (1999, p.119) therefore suggests in summary that:

Children vary in their vulnerability to psycho-social stress and adversity as a result

of both genetic and environmental influences; that family-wide experiences tend to

impinge on individual children in quite different ways; that the reduction of

negative, and increase of positive, chain reactions influences the extent to which the

effects of adversity persist over time; that new experiences which open up opportunities,

can provide beneficial ‘turning-point’ effects; that although positive

experiences in themselves do not exert much of a protective effect, they can be

helpful if they serve to neutralise some risk factors; and that the cognitive and

affective processing of experiences is likely to influence whether or not resilience

develops.

1.17 These findings have led writers such as Buchanan (1999) to talk about the importance

of mobilising clusters of protective factors for children even in the most unpromising

situations. This constitutes an important consideration in assessment and intervention.

One of the key protective factors identified by researchers is successful school

experience. Furthermore, having a parent who promotes the importance of education

is another vital factor (Utting, 1996):

One of the most significant protective factors found in the backgrounds of children

from disadvantaged homes whose attainment is above average is having a parent

who displays a keen interest in their education.

Writers such as Jackson (1987), Cleaver (1991), Katz et al (1997), Buchanan and

Hudson (1998) and Sinclair (1998) provide ample evidence of why ‘any consideration

of how to meet the needs of a child must include their education’ (Sinclair, 1998, p.5).

6

7

1. Reproduced with kind permission of the authors. From: Falkov A (ed) ( 1998) Crossing Bridges. Training resources for

working with mentally ill parents and their children. Reader – for managers, practitioners and trainers. p.72. Pavilion

Publishing, Brighton.

Table 11 Risks/stressors and protectors/resources relevant to children

Risk/stressor Factor Protector

Intrinsic

Younger Age Older

Male Gender Female

General or specific learning disabilities, Development Good cognitive and

developmental disorder, lack of educational (language and cognitive language abilities

skills abilities) and education skills

Chronic physical illness/disability Physical health Healthy

Predisposition to mental disorder, or increased risk Genetics No adverse predisposition

Difficult Temperament Easy

Belonging to minority – being ‘different’ Ethnicity Belonging to majority

experience of oppression, discrimination, racism group

Immediate circumstances

Discordant/distant Parent-child relationship Warm/mutual

Lax/hostile/no control Parenting Positive, eg. co-operation

Neglect, abuse and good control,

age-appropriate

interactions

Distant/discordant/violent Inter-parental relationship Mutually

supportive/co-operative

Comorbidity, both parents ill, single parent ill Parental mental health Partner well

Absent/discordant/oppressive Sibling and peer relationships Warm/supportive

Material hardship Socio-economic resources Financially secure

Crowded, unhygenic Housing Good, spacious

Poor ethos, low support, bullying, punitive School Good ethos, supportive

Absent supports, anti-social influences Community Support, provision of child

activities

Life events

Loss and other negative life events and Life events and experiences Positive life events,

experiences acknowledgement of

achievements

1.18 The ability to differentiate the vulnerabilities and strengths of children at different

ages and stages of development is critical in assessment. The neglect of some of these

issues for adolescents is increasingly being remedied. Cleaver (2000a) provides

summaries of research findings of the relevant factors for different age groups,

including children over 10 (Table 2).

8

Vulnerabilities Strengths

Coping with puberty without support. Factual information about puberty, sex

and contraception.

Denying own needs and feelings. A mutual friend.

Unstigmatised support of relevant

professionals.

An increased risk of psychological The ability to separate themselves either

problems, behavioural disorders, psychologically or physically from

suicidal behaviours and offending. stressful situations.

Low self-esteem.

Poor school attainment due to: Regular school atttendance.

difficulties in concentration, poor Sympathetic, empathic and vigilant

attendance in order to look after parents teachers.

or younger children, unacceptable A champion who acts vigorously on

behaviour resulting in a pattern of behalf of the child.

school exclusion. For those no longer in school, a job.

The fear that revealing family problems A mentor or trusted adult with whom the

will lead to the family being broken up. child can discuss sensitive issues.

This may result in increased isolation Practical and domestic help.

from friends and adults outside the family.

Increased risk of abuse. An alternative, safe and supportive

Inappropriate role models. residence for children and young people

subjected to violence or the threat of

violence.

Children’s perspectives

1.19 Finally, children’s own perspectives on their experiences are an important source of

knowledge. Increasingly, the validity of children’s views on their lives is acknowledged

in research. Children have views about what is happening to them. They attach

meaning to events. They have wishes and feelings which must be taken into account

and they will have ideas about the direction of decisions and the way in which those

decisions are executed (for example, Butler and Williamson, 1994; Shaw, 1998;

Table 22 Vulnerabilities and strengths for children aged 10–14 years and teenagers

15 years and over

2. Reproduced with kind permission of the author. From: Cleaver H (2000a) When parents'

issues influence their ability to respond to children's needs. In Horwath J (ed) The Child's World:

Assessing Children in Need. The Reader. The NSPCC, London.

Brandon et al, 1999; Department of Health, forthcoming). Thomas and Beckford

(1999), in their study of adopted children speaking, emphasise the importance of

work with children being ‘underpinned by good adult-child and child-adult

communication’. The responsibility for trying to establish effective communication

lies firmly with the adults. They identify the following imperatives for the adults

involved (pp.131–132):

_ Express themselves simply and clearly and use concepts which are familiar to

children;

_ Match their explanations of new ideas to the children’s age and levels of

understanding;

_ Be aware of the possible impact of emotional distress on children’s understanding;

_ Elicit children’s fears and offer reassurances;

_ Allow children plenty of opportunities for asking questions;

_ Ask children for feedback to see if information and explanations have been

remembered and understood;

_ Repeat, simplify, expand and build on explanations if appropriate;

_ Use communication tools such as games, prompt cards, books and videos.

Innovative materials for use with children and young peoples of different ages and in

different circumstances have been developed which assist good communication.

Examples are included in Chapter 4.

Parental capacity

1.20 Optimal child development is dependent on the positive role of parents or caregivers

from children’ s birth to adulthood. However, it is recognised that there can be a

diversity of family styles (Department of Health, 1989, p.7):

Although some basic needs are universal, there can be a variety of ways of meeting

them. Patterns of family life differ according to culture, class and community and

these differences should be respected and accepted. There is no one perfect way to

bring up children and care must be taken to avoid value judgements and stereotyping.

1.21 Rosenfeld et al (1986) add a note of caution about understanding parents’ behaviours.

They emphasise that just because a behaviour is normative does not necessarily mean

it is optimal for child development.

1.22 However, children’s chances of achieving optimal outcomes will depend on their

parents’ capacities to respond appropriately to their needs at different stages of their

lives. There are many factors in parents that may inhibit their responses to their

children and prevent their providing parenting to a level necessary to promote optimal

outcomes in children. The number of parents who set out to cause harm to their

children is very small. The majority of parents, including most of those who neglect or

maltreat their children, want to do the best for their children and have their best

interests at heart. However, as Rutter (1974) (quoted by Utting (1995)) suggests:

9

Good parenting requires certain permitting circumstances. There must be the

necessary life opportunities and facilities. Where these are lacking even the best

parents may find it difficult to exercise these skills.

Most of the parents interviewed by Thoburn et al (2000) were well aware that their

standard of parenting at times failed to meet their children’s needs.

1.23 Belsky and Vondra (1989) identify the multiple determinants of parenting. They can

be summarised as follows:

_ Individual

(parental personality, child characteristics)

_ Historical

(parental developmental history)

_ Social

(partner satisfaction, social support network)

_ Circumstantial

(poverty; job dissatisfaction; ignorance about child development)

1.24 There are, therefore, many factors that may inhibit parenting responses, including

parents’ life experiences as adults and in childhood. Reder and Duncan (1999) suggest

that parents’ own childhood experiences may spill over into adult life. For instance,

experiences of rejection, abandonment, neglect and feeling unloved as a child may be

associated with excessive reliance on others and fear of being left, or excessive

distancing from others and fear of dependency in adulthood. As with children, it is

important to understand both the nature of the adversity parents have experienced

and the level of any protective factors which can build resilience in adult life to help

overcome adversity. For example, the important research of Rutter and colleagues on

intergenerational factors showed that the presence of a supportive partner in

adulthood could help counteract negative experiences of growing up in care (Rutter

and Rutter, 1992).

1.25 Some parents may have serious health problems or impairments which may place

upon children responsibilities inappropriate to their years unless informal support

and appropriate services are provided for the family, in consultation with the child

(Aldridge and Becker, 1999; Tucker et al, 1999). It is therefore necessary for social

workers to understand what may inhibit parental responses to children and what the

consequences of that inappropriate response may be for children of different ages.

1.26 Research studies (Department of Health, 1995; Department of Health, forthcoming)

have suggested that, among problems likely to affect parenting are mental illness,

problem alcohol and drug use and domestic violence (Buchanan (ed), 1994; Cleaver

and Freeman, 1995; Reder and Lucey, 1995; Falkov, 1996; Brandon et al, 1999;

Cleaver et al, 1999; Thoburn et al, 2000; Department of Health, forthcoming). A

study for the Department of Health by Falkov of local reviews of deaths and serious

injuries to children revealed that in a significant proportion, mothers were suffering

from identifiable mental illnesses (Falkov, 1996). Cleaver et al (1999) particularly

emphasise the damaging effects for a child of living with and witnessing domestic

violence between adult members of the household.

10

1.27 It is important, therefore, that practitioners understand the impact of parental

responses on the particular child. A two year old may be at risk of significant harm

from a parent whose practical caring skills are diminished by a misuse of drugs or

alcohol but a sixteen year old in a similar situation may be able to remain relatively

unharmed. Understanding the interaction between parents’ responses and capabilities

and children’s needs is a key principle underpinning effective assessment and

intervention. As Cleaver (2000a) points out, not all children are equally vulnerable to

the adverse consequences of parental problems.

1.28 Research suggests (Cleaver et al, 1999) children are less likely to be adversely affected

when parental problems are:

_ Mild and of short duration;

_ Not associated with family violence, conflict and disorganisation;

_ Do not result in the family breaking up.

Children may also be protected when other responsible adults are involved in child

care, or assume the role of the child’s champion or mentor. Careful account should be

taken, therefore, of the context within which the parent or parents may be experiencing

problems and the impact of parental behaviour on the child.

1.29 Some parents may be directly responsible for maltreating their children. Bentovim

(1998, p.57) argues that ‘significant harm represents a major symptom of failure of

adaptation by parents to their role’:

It may be useful to think of significant harm generally as a compilation of significant

events, both acute and long-standing, which interact with the child’s ongoing

development, and interrupt, alter, or impair physical and psychological

development. Being the victim of significant harm is likely to have a profound effect

on a child’s view of themself as a person, and on their future lives. Significant harm

represents a major symptom of failure of adaptation by parents to their role, and

also involves both the family and society.

1.30 Writers such as Adcock (1998) and Brandon et al (1999) draw an important

distinction between significant harm and abuse. Adcock (1998, p.35) argues that:

Significant harm needs to be understood separately from child abuse or neglect,

although the two may coexist. The two can be differentiated by the idea that child

abuse describes acts and omissions, significant harm describes effects . . . Ill Treatment

may lead to the impairment or likely impairment of health and development . . .

Some children may need protection to prevent the recurrence (of ill treatment); any

child whose health or development has been impaired may need services to deal

with consequences of this.

1.31 Not only parent figures or caregivers maltreat children. Additionally, children may be

abused by siblings. Outside their families, children may also be at risk of encountering

perpetrators. Utting (Department of Health and Welsh Office, 1997) has drawn

attention to the particular dangers of child sexual abuse for children living away from

home. It is important to understand why adults or other children maltreat children.

Social workers should inform themselves about the characteristics of personality and

behaviour, profiles and methods of perpetrators of different forms of child

11

maltreatment, including physical, sexual and emotional abuse, both where children

are living with their families and elsewhere (Department of Health, 2000a).

Parents’ Perspectives

1.32 Parents’ views about their contact with child welfare and other statutory services have

been well documented, particularly when there have been child protection concerns

(for example, Cleaver and Freeman, 1995; Farmer and Owen, 1995; Jones and

Ramchandani, 1999; Thoburn et al, 2000). Aldgate and Bradley (1999) in their study

of short-term accommodation found how these experiences influenced parental

worries about asking for help from social services when they needed assistance.

Parents’ worries were about:

_ being vulnerable to child protection enquiries and being afraid of losing their

children;

_ being perceived as failed parents;

_ the impact of using short term accommodation on their children and being

detrimental to their future relationship with them.

1.33 The sense of losing control once child welfare agencies are involved is keenly felt by

parents. They want help but not at the cost of forfeiting their parenting responsibilities.

Ghate and Hazel (forthcoming) found in a national study of parenting in poor

environments that parents’ wish to stay in control of the delivery of support services

was an overriding theme.

1.34 What parents value from child welfare agencies is clearly detailed in studies of family

support services (see Butt and Box, 1998; McAuley, 1999; Social Services Inspectorate,

1999; Tunstill and Aldgate, 2000), in studies of contact (Cleaver, 2000b) and of

court processes (Hunt et al 1999) and includes:

_ communication which is open, honest, timely and informative;

_ social work time with someone who listens, gives feedback, information,

reassurance and advice, and is reliable;

_ services which are practical, tailored to particular needs and accessible;

_ an approach which re-inforces and does not undermine their parenting capacity.

These issues are explored further in later chapters in this practice guidance.

Theories and myths of the individual in society

1.35 Alongside the theories concerned with the development of individuals are those

related to the individual in society. There is a wealth of knowledge from sociological

and psychological research which provides important background material for

understanding the impact of negative factors such as social exclusion, racial and other

discrimination, deviancy and unsafe communities on the children and families with

whom practitioners will come in contact. Of particular relevance in assessment are

sociological theories concerned with the issues of social exclusion and use or misuse of

power, such as social constructionism and stereotyping. Writing on the identification

12

of child abuse, for example, Parton (1987) discusses how the parameters of child abuse

have changed over time.

1.36 Good outcomes for children have sometimes been blocked by assumptions which

tend to stereotype families. This is especially pertinent in relation to black children.

Ahmed et al (1986), for example, were among the first black British writers in social

work to emphasise the negative impact of institutional racism on service provision for

black children and their families. The picture from recent research is complex. Some

research suggests that black and other minority ethnic groups are under-represented as

service users receiving preventive and supportive social services (Tunstill and Aldgate,

2000). However, when black and minority ethnic families are referred to social

services, it is less likely to be about concerns of maltreatment but more likely to be with

a request for a specific service (Thoburn et al, 2000). The following chapter by Dutt

and Phillips provides a helpful comparison of black and white families in relation to

the assessment of children’s needs. They draw attention to factors such as family

structures, cultural values, and discuss the myths and realities of black family

networks. Accurate information of this type helps to remove confusion and

uncertainty and avoids stereotyping of children and families.

1.37 It is also important not to confuse theory with ideology. Work with children and

families has sometimes been subject to fashionable ideologies which may dictate the

style of work adopted. Ideological approaches, for example, ‘all children should be in

family based care because residential care is bad for them’ or ‘siblings should be kept

together at all costs’ should never get in the way of ethical and professional practice

which discriminates effectively in relation to the developmental needs of a particular

child.

Wider family, community and environmental factors

1.38 The role of the wider family can be a significant source of support. Conversely,

extended families may not always be supportive. Sometimes, even when families live

nearby, links are not maintained (Aldgate and Bradley, 1999). Thoburn et al (2000)

found that, at times, the stresses within the whole family were such that grandparents

and other relatives could not find a way to help, or were too caught up in their own

problems. Some parents do not always wish to acknowledge to their wider kin that

they are not coping with a burgeoning problem. However, Brandon et al (1999) found

that when problems became serious, extended family members are likely to rally

round to provide protection and care.

1.39 Similarly, the contribution of the community in providing practical and emotional

support to the immediate family also needs to be understood. Living in a supportive

community may offer considerable help to parents. It may be important to chart both

families’ interrelationships over time and their current wider connections in the

communities in which they live. Genograms and Ecomaps may be useful means of

doing this with families (Appendices 2 and 3 respectively).

1.40 Social isolation, through an absence of both physical and emotional support, is an

important factor in limiting adults’ sense of wellbeing and control over their lives (see

Argyle, 1992; Coohey, 1996; Aldgate and Bradley, 1999). Research from HomeStart

has also suggested that social isolation is one of the major reasons for referral for

13

befriending support (McAuley, 1999). A two year survey of referrals to HomeStart

(Northern Ireland) indicated that the predominant referrers were health visitors and

that the five main reasons for referrals were:

_ Mother’s mental health (with postnatal depression being most prevalent);

_ Mother’s physical health;

_ Multiple births/multiple young children;

_ Child/ren’s special needs eg. health problems;

_ Mother’s isolation/loneliness.

1.41 Where social isolation is combined with fears for personal safety because of a hostile

neighbourhood, cumulative negative factors can have an impact on parents’ mental

and physical health. Additionally, the part the wider family and others may play in

organised abuse needs to be understood (Cleaver, 1996). This includes the threats to

children from dangerous individuals in unsafe communities.

1.42 Finally, there is considerable evidence which catalogues the impact of the

environment on parental capacity. The impact on families’ health and wellbeing is

well known (for example, Bradshaw, 1990; Utting, 1995; Acheson, 1998). The day to

day meaning of living on a low income is summarised by Amin and Oppenheim

(1992, p.36), who describe material disadvantage as:

...a kind of partial citizenship, since the effects of material deprivation make it very

difficult to participate in society as a full member...

1.43 The importance of recognising the interface between families and the communities in

which they live has recently been identified by the Social Exclusion Unit (1998, p.9):

While most areas have benefited from rising living standards, the poorest

neighbourhoods have tended to become more rundown, more prone to crime and

more cut off from the labour market.

1.44 Writers such as Jack (1997) and Stevenson (1998) have been concerned at the

omission of environmental considerations from the social work process. Research

studies have shown the strong association between economic disadvantage and living

conditions and the chances that children will fail to thrive (Utting, 1995; Iwaniec,

1996). Differences are clearly apparent in the health and educational development of

children growing up in areas of deprivation. This has its impact both on young adults’

ability to succeed as effective parents and directly on children themselves, through the

standards of school available to them, the sub-culture of peer groups with whom they

relate and the community facilities provided.

1.45 Holman at a conference in 1998 put it starkly: ‘Poverty undermines parenting’. The

meaning of living in continuing poverty is exemplified by Anita in her account of

bringing up her children in an environment of social deprivation, in Holman’s Faith in

the Poor (1998, pp.96–98):

Poverty is a terrible thing. I just cannot cope with what I am getting on income

support. I just wish I could feed and clothe my children but it is impossible with

what I receive . . . I am really worried about the kids growing up in Easterhouse . . .

I know in my heart they will either turn to drugs or end up in prison. My kids keep

asking to move. They are lovely kids and intelligent and I would dearly love to see

14

them make something of themselves . . . but what can I do with no money? My

children don’t stand a chance.

1.46 Bebbington and Miles (1989) have demonstrated how the cumulative effect of

disadvantage can dramatically increase a child’s chances of coming into the care

system:

15

Child ‘A’ Child ‘B’

Aged 5–9 Aged 5–9

No dependence on social security benefits Household head receives income support

Two parent family Single adult household

Three or fewer children Four or more children

White Mixed ethnic origin

Owner occupied home Privately rented home

More rooms than people One or more persons per room

Odds are 1 in 7,000 Odds are 1 in 10

1.47 The relationship between disability and disadvantage is also important and has not

always been well understood. This is well evidenced in the study by Lawton (1998) of

families with more than one disabled child (of which there are some 17,000 in the

United Kingdom). Such families are:

_ more likely to be single parents;

_ less likely to be in work;

_ more likely to be in semi-skilled or unskilled jobs;

_ more likely to be dependent on income support;

_ less likely to own their own home;

_ more likely to report housing as unsuitable;

_ more likely to have extra costs

This study serves to reinforce the importance of considering the wider context in

which families are caring for and bringing up disabled children (issues which are

discussed more fully in Chapter 3).

1.48 The evidence suggests that the families of many children in need who are most

disadvantaged are those living in poverty, in poor housing, without adequate social

supports and in the poorest, hostile neighbourhoods. These families face multiple

stresses which are interlinked. McAuley (1999) includes the following example in her

study.

Table 3 The cumulate effect of disadvantage

Overarching theories and approaches that inform practice

1.49 Practitioners have the arduous task of making sense of the wealth of theory and

knowledge informing their assessments. Psychodynamic and learning theories help to

understand the inner and outer worlds of children and families, while eco-systems

theory provides a very helpful framework to analyse the interconnections between

personal and environmental factors which have an impact upon the lives of children

and families. These are more fully discussed in Seden’s review of the literature on

assessment of children and their families (Department of Health, 2000b).

1.50 The ecological approach takes the view that individuals are connected to and interact

with the environment in which they live. The approach is well established in the social

sciences (Siporin, 1975; Maluccio, 1981; Garbarino, 1982). A key exponent of this

theory, Bronfenbrenner (1979) outlines its relevance to social work with children and

families. He places children’s lives in the context of a series of systems: the immediate

settings of home, school, friendship group and their interrelationship; local social

structures which influence those settings; and the larger institutional patterns of

economic, social, educational, legal and political systems. Updated applications of

ecological theory are to be found in the paper by Jack (1997), in Stevenson’s study of

neglected children (1998), and in relation to child maltreatment by Jones and

Ramchandani (1999).

1.51 Workers have at their disposal knowledge of human growth and development in

children and families, knowledge of the environment and community and of the

interaction between all these elements. A concrete example of how different and

interconnecting knowledge and systems may be translated into practice in relation to

16

Example of interplay of factors causing stress

The parents had two children under five years of age. The mother had had a medical

condition for some time, but her health suddenly deteriorated, leaving her unable to walk.

She had been admitted to hospital immediately. On her return home, she fell whilst

attempting to walk in her home and broke her arm. Her husband had been off work with

ill health. She went on to describe her predicament when the HomeStart Organiser first

came to see her:

I was completely useless. I couldn’t even, obviously with a plaster cast on, I couldn’t

do something as simple as wash myself. I could just about feed myself and no more.

P (her husband) had to basically cut up my meals for me. I couldn’t change S’s

nappies or wash or iron. Those were things I had always done and P was having to

do that. And he couldn’t do that and look after the kids. It just really . . . .everything

sort of went to pot . . . It was every kind of stress and with him being off for two

years with no wages, we couldn’t pay someone to come in and help us . . . My kids

have never been separated from me before . . When I came home (from hospital)

they were extremely insecure . . they really took my hospitalisation majorly badly . . .

Any kind of disappearance at all, be it only for a few seconds to the back garden,

you know, the kids panicked and were in hysterics and had to be completely

reassured.

McAuley (1999, pp.33–34)

child maltreatment comes from Jones and Ramchandani (1999) in Figure 3. Similarly

helpful examples can be found in Crossing Bridges (Falkov (ed), 1998, p.75) and the

work of Capaldi and Eddy (in press) in relation to children with conduct disorders.

1.52 As Cox (1993) and others have pointed out, what is significant for a family may be the

processes generated by an event or events which may interact with the child’s needs

and the surrounding vulnerabilities and protective factors. The event or events may set

off a cycle or chain of interaction. In assessing what is happening to a child and family,

thought is required about the process which has been generated and the maintenance

of momentum. The importance of context is therefore critical in understanding the

relationship between outcomes and those events which act as stressors. Reder and

Duncan (1999) provide a useful summary of the key issues which should be kept in

mind during the assessment process:

1.53 Another way of understanding what is happening in family functioning draws from

the systemic approach which has evolved from cybernetic theory or the study of

communication. The theory focuses on people in their current social and economic

context and the beliefs underpinning their behaviour. It seeks to explain human

problems in terms of relationships rather than individual characteristics or pathology.

Problems in systems often arise from attempts to adjust to life events and are linked to

notions of circular and reciprocal cause and effect. The systemic practitioner,

therefore, seeks to identify repetitive sequences of interaction which maintain and are

maintained by the original or subsequent problems. Accounts of the development and

use of the theory are found, for example, in Gorrell-Barnes (1994) and White and

Epston (1990).

1.54 Both systems and ecological models consider how the support services, including

social workers and other professionals, add to or detract from the family’s coping

mechanisms.

Methods of intervention

1.55 During the process of assessment, workers will be thinking about interventions that

will best help children and families. The choice of intervention will be governed by

many factors. Among these will be the appropriate application of social work

methods. These methods have been developed from a range of psychosocial theories.

17

Key issues for assessment

_ Context gives meaning to behaviour

_ Individuals exist in relationships to others

_ Relationship and communication are a function of each other

_ Current relationships arise out of historical influences

_ Interactions revolve around the meaning of one person for another

_ There is circularity between a person’s inner and outer world

Reder and Duncan (1999)

18

Figure 3 A developmental and ecological perspective on child maltreatment

Parent's

childhood

Parent's

childhood

Parent's

childhood

Reabuse, child safety

Child's attributions/coping

Parent/child relationship

Social and family support

Professional response

Therapy

School

Effective development

outcome

Ineffectual/Problematic

———————————

Behaviour

Affective development

Cognitive

Relationships

Socialisation

Personality

Physical sequelae

Cultural and social influences

Family

Parent/Child

School Neighbourhood

Child

Relationship

Extended Family

Social contacts Work

PRE-EXISTING INFLUENCES SETTING FOR ABUSE

(Ecology of maltreatment)

INTERVENING FACTORS

(Compensatory or potentiating)

OUTCOME

(Adaptive or maladaptive)

Reproduced with kind permission of the authors.

From: Jones D and Ramchandani P (1999) Child Sexual Abuse. Informing Practice from Research. Radcliffe Medical Press, Abingdon.

The methods include psychosocial casework, cognitive behavioural work,

counselling, family therapy, task-centred casework, crisis intervention and so forth.

Part of the assessment will be to think about which particular method will be best

suited to the needs of individual children and their families. The approach must be

eclectic. Workers may have their favoured approaches but it is not appropriate to use

one method in all circumstances to the exclusion of all others. Choice of method

should also be influenced by knowledge of what works in particular circumstances.

For example, Jones and Ramchandani (1999), in writing about child sexual abuse,

conclude that the ‘best available evidence points to the use of focused therapies based

on a cognitive-behavioural model being the most effective way of treating these

symptoms’. However, they warn that ‘no single therapy has demonstrable benefits for

all children who have been sexually abused’ (Jones and Ramchandani,1999, p.72).

Texts based on clinical work like that of Jewett (1982) on helping children manage

separation and loss, Fahlberg’s (1991) work on children in transitions, and examples

of clinical practice in direct work with children from Aldgate and Simmonds (1988)

all have a major contribution to play in building up a repertoire of methods of

intervention rooted in theory, research and good practice.

Roles and tasks of child and family workers

1.56 Of course in practice it is very difficult to separate the boundaries between assessment

and intervention. Having established what is happening to a child within the context

of his or her family and environment and the impact on the child, the purpose of

assessment will change (Jones, 1998, p.111):

Later on, the process develops into an assessment of the likelihood of change,

followed by whether such change is achieved. Looked at this way, assessment

continues throughout intervention.

1.57 Another important dimension of assessing the appropriate intervention is the decision

whether the child remains at home or is looked after away from home, and whether

this should be on a short term or permanent basis. Where a child is looked after, it will

be important to consider all the factors surrounding placement choice, including

plans for reunification and adoption (Thoburn et al, 1986; Department of Health,

1989; Department of Health, 1991b; Department of Health, 1999). Any decisions

which involve changes for children must take account of their developmental needs.

Principles of stability and continuity are important for children at any level of

intervention, as are principles of safeguarding and promoting children’s welfare.

1.58 Furthermore, the communication skills and interactions required to gather

information will inevitably trigger in some children and families the beginning of

problem solving processes. Recent research on family support has suggested that a

short encounter between a social worker and a family to assess difficulties may be in

itself a problem solving experience. The exchange and synthesis of information

between family members and the worker may be enough to help the family without

further social work intervention. At the other end of the continuum, long-term help

will be necessary for a significant number of families (Department of Health,

forthcoming). Schofield and Brown (1999) and Thoburn et al (2000) urge that

workers remember the importance of the professional relationship between worker

and children and families in any direct encounter with families.

19

1.59 Methods of intervention are only part of the knowledge base that practitioners need

for assessment. They are important because good assessments are built on an

integration of theory and practice. Knowledge is being continually developed by

research findings and the evolution of new and existing theories. These include

knowledge about child development, parenting and the impact of parental

difficulties, and the significance of environmental factors. Work with children and

families does not take place within a vacuum but in an organisational and legislative

context. Understanding the roles and tasks of a worker, not only within the context of

his or her own agency but also taking account of the roles and tasks of other workers

and the contexts of agencies which are likely to be contributing to the promotion of

the welfare of the child, is another area of knowledge essential to the assessment

process. In this respect, it is also important to take account of the impact of agency

factors on outcomes for children.

1.60 Effective collaboration between workers in different agencies is notoriously difficult to

achieve. Recognition that inter-agency co-operation is required is not new. Hallett

and Stevenson (1980) cite ‘a government circular (Home Office, 1950) on ill-treated

children which recommended the establishment of children’s co-ordinating

committees’ (p.1). However, the difficulties and ‘failures’ in inter-agency working

have been well documented in reviews of individual cases of child maltreatment and in

more broadly based research studies (Department of Health and Social Security, 1982;

Department of Health, 1991a; Department of Health, 1995; Hallett, 1995). Hudson

(2000) helpfully explores these issues, noting that governments have again and again

exhorted public sector services to work more closely together (p.235):

There is a paradox here, with ‘collaboration’ seen as both problem and solution –

failure to work together is the problem, therefore the solution is to work together!

1.61 He gives a salutory reminder that the literature constantly focuses on the barriers to

collaboration including structural, professional, financial, status and legitimacy

factors, but that ‘inter-organisational relationships are largely built upon human

relationships’ (p.254). Some of the important messages for collaborative working

which practitioners should understand are summarised below:

The challenge of evidence based work

1.62 The Introduction to this practice guidance emphasised the importance placed on

evidence based practice. This is a marked shift from thinking about evidence only as

20

Collaborative Working: General Messages

_ Reciprocity is the basis of collaboration

_ Collaboration is a continuum with choices

_ Collaboration requires a consensus of stakeholders

_ Collaboration requires an expression of purpose

_ Trust is essential to collaborative success

Hudson et al (1999)

part of judicial processes. Rowe drew this out succinctly in Patterns and Outcomes in

Child Placement (Department of Health, 1991b, pp.77–78):

Social workers tend to think of evidence in terms of court hearings and reports, but

evidence in the sense of ‘facts which lead to conclusions’ must be at the heart of

every decision. The whole child care service, from strategic planning to monitoring

of individual outcomes, is permeated by questions of evidence. Gathering, testing,

recording and weighing evidence are tasks basic to professional competence, but are

seldom addressed in these terms… Decisions can only be as good as the evidence on

which they are based…

1.63 Throughout the Framework for the Assessment of Children in Need and their Families

(Department of Health et al, 2000) and the materials produced to accompany the

guidance, the sources of knowledge which have been used have been referenced and

discussed to assist practitioners to develop their own knowledge base. However,

evidence based practice also refers to the process whereby practitioners gather relevant

information about what is happening to a child and use their knowledge from research

findings, theoretical ideas and practical experience to arrive at a greater understanding

of a particular child and family’s experiences. Reder and Duncan (1999) provide a

helpful discussion of this process, emphasising the importance of the application of

knowledge at each stage of work with children and families. They refer to this as the

development of a ‘dialetic’ mindset (p.98):

Put at its simplest, assessment comes before action and the impact of actions needs

to be monitored. Therefore, assessment should be an evolving process in which

thought and action are reciprocal. Actions are guided by thought and the

consequences of action are noted, considered and fed back to influence further

action.

1.64 Thus, evidence based work also requires the careful use of knowledge gained during

work with a child and family to undertake the task of determining what is most

relevant in a family’s situation, what is most significant for the child, the impact

intervention is having and the judgement about when more or less action is required

in the child’s best interests.

1.65 Hunt et al (1999), in their study of the use of courts following the implementation of

the Children Act 1989, explore the challenge of an evidence based approach for practitioners

in that context (p.391):

The new criteria for statutory intervention, for instance, and the emphasis on

partnership with parents, place a premium on the capacity of social workers and

their managers to evaluate evidence and manage risk, to develop skills at working

with families in a voluntary framework and judging the point at which it is not

viable. Once a case comes to court the social worker is expected to present coherent

written evidence on what may well now be a more complex involvement with the

family, be au fait with court procedures and be a competent witness even though the

opportunities to accumulate court experiences are less frequent.

1.66 Although the principle of evidence based practice applies to all professionals who

work with children and families, it is perhaps social work practitioners who are experiencing

the challenge most keenly. It is essential for effective assessment of children in

need and their families that social work is a confident profession, particularly in the

21

context of inter-agency collaboration with other professionals. This requires social

workers to be sure of their professional expertise and the knowledge on which they

draw to form their professional judgements. Higham (Community Care, 1999) sums

up this challenge:

If social work is to develop further in the twenty-first century, practitioners must

not rely soley on practice wisdom for decision making but use evidence based

knowledge … Social work beyond the millennium needs to come of age. This will

happen when social workers find an effective voice, develop new roles and establish

a better knowledge base for their practice.

22

23

MARY SHERIDAN

Posture and large

movements

Vision and fine

movements

Hearing and speech

Social behaviour

and play

1 MONTH

Lies back with head to one side; arm and leg on

same side outstretched, or both arms flexed; knees

apart, soles of feet turned inwards.

Large jerky movements of limbs, arms more active

than legs.

At rest, hands closed and thumb turned in.

Fingers and toes fan out during extenor movements

of limbs.

When cheek touched, turns to same side; ear gently

rubbed, turns head away.

When lifted or pulled to sit head falls loosely

backwards.

Held sitting, head falls forward, with back in one

complete curve.

Placed downwards on face, head immediately turns

to side; arms and legs flexed under body, buttocks

humped up.

Held standing on hard surface, presses down feet,

straightens body and often makes reflex ‘stepping’

movements.

Turns head and eyes towards light.

Stares expressionlessly at brightness of window or

blank wall.

Follows pencil flash-lamp briefly with eyes at 1 foot.

Shuts eyes tightly when pencil light shone directly

into them at 1–2 inches.

Notices silent dangling toy shaken in line of vision at

6–8 inches and follows its slow movement with eyes

from side towards mid-line on level with face

through approximately quarter circle, before head

falls back to side.

Gazes at mother’s nearby face when she feeds or

talks to him with increasingly alert facial expression.

Startled by sudden loud noises, stiffens, quivers,

blinks, screws eyes up, extends limbs, fans out

fingers and toes, and may cry.

Movements momentarily ‘frozen’, when small bell

rung gently 3–5 inches from ear for 3–5 seconds,

with 5 second pauses; may ‘corner’ eyes towards

sound.

Stops whimpering to sound of nearby soothing

human voice, but not when screaming or feeding.

Cries lustily when hungry or uncomfortable.

Utters little gutteral noises when content.

(Note: Deaf babies also cry and vocalise in this reflex

way, but if very deaf do not usually show startle

reflex to sudden noises. Blind babies may also move

eyes towards a sound-making toy. Vision should

always be checked separately.)

Sucks well.

Sleeps much of the time when not being fed or

handled.

Expression still vague, but becoming more alert,

progressing to social smiling about 5–6 weeks.

Hands normally closed, but if opened, grasps

examiner’s finger when palm is touched.

Stops crying when picked up and spoken to.

Mother supports head when carrying, dressing and

bathing.

3 MONTHS

Now prefers to lie on back with head in mid-line.

Limbs more pliable, movements smoother and more

continuous.

Waves arms symmetrically. Hands now loosely

open.

Brings hands together from side into mid-line over

chest or chin.

Kicks vigorously, legs alternating or occasionally

together. Held sitting, holds back straight, except in

lumbar region, with head erect and steady for

several seconds before bobbing forwards. Placed

downwards on face lifts head and upper chest well

up in mid-line, using forearms as support, and often

scratching at table surface; legs straight, buttocks

flat.

Held standing with feet on hard surface, sags at

knees.

Visually very alert, particularly interested in nearby

human faces.

Moves head deliberately to look around him.

Follows adult’s movements near cot.

Follows dangling toy at 6–10 inches above face

through half circle from side to side, and usually also

vertically from chest to brow.

Watches movements of own hands before face and

beginning to clasp and unclasp hands together in

finger play.

Recognises feeding bottle and makes eager

welcoming movements as it approaches his face.

Regards still objects within 6–10 inches for more

than a second or two, but seldom fixates

continuously.

Comerges eyes as dangling toy is moved towards

face. Defensive blink shown.

Sudden loud noises still distress, provoking blinking,

screwing up of eyes, crying and turning away.

Definite quietening or smiling to sound of mother’s

voice before she touches him, but not when

screaming.

Vocalises freely when spoken to or pleased.

Cries when uncomfortable or annoyed.

Quietens to tinkle of spoon in cup or to bell rung

gently out of sight for 3–5 seconds at 6–12 inches

from ear.

May turn eyes and head towards sound; brows may

wrinkle and eyes dilate.

Often licks lips in response to sounds of preparation

for feeding.

Shows excitement at sound of approaching

footsteps, running bath water, voices, etc.,

(Note: Deaf baby, instead, may be obviously

startled by mother’s sudden appearance beside cot.)

Fixes eyes unblinkingly on mother’s face when

feeding.

Beginning to react to familiar situations – showing

by smiles, coos, and excited movements that he

recognises preparation for feeds, baths, etc.

Responds with obvious pleasure to friendly

handling, especially when accompanied by playful

tickling and vocal sounds.

Holds rattle for few moments when placed in hand,

but seldom capable of regarding it at same time.

Mother supports at shoulders when dressing and

bathing.

APPENDIX 1

Chart illustrating the developmental progress of infants and young children

24

Posture and large

movements

Vision and fine

movements

Hearing and speech

Social behaviour

and play

6 MONTHS

Lying on back, raises head from pillow.

Lifts legs into vertical and grasps foot.

Sits with support in cot or pram and turns head from

side to look around him.

Moves arms in brisk and purposeful fashion and

holds them up to be lifted.

When hands grasped braces shoulders and pulls

himself up.

Kicks strongly, legs alternating.

Can roll over, front to back.

Held sitting, head is firmly erect, and back straight.

May sit alone momentarily.

Placed downwards on face lifts head and chest well

up, supporting himself on extended arms.

Held standing with feet touching hard surface bears

weight on feet and bounces up and down actively.

Visually insatiable: moves head and eyes eagerly in

every direction.

Eyes move in unison: squint now abnormal.

Follows adult’s movements across room.

Immediately fixates interesting small objects within

6–12 inches (eg, toy, bell, wooden cube, spoon,

sweet) and stretches out both hands to grasp them.

Uses whole hand in palmar grasp.

When toys fall from hand over edge of cot forgets

them.

(Watches rolling balls of 2 to 1/4 inch diameter at

10 feet).

Turns immediately to mother’s voice across room.

Vocalises tunefully and often, using single and

double syllables, eg. ka, muh, goo, der, adah, er-lah.

Laughs, chuckles and squeals aloud in play

Screams with annoyance.

Shows evidence of response to different emotional

tones of mother’s voice.

Responds to baby hearing test at 11/2 feet from each

ear by correct visual localisation, but may show

slightly brisker response on one side.

(Tests employed – voice, rattle, cup and spoons,

paper, bell; 2 seconds with 2 seconds pause.)

Hands competent to reach for and grasp small toys.

Most often uses a two-handed, scooping-in

approach, but occasionally a single hand.

Takes everything to mouth.

Beginning to find feet interesting and even useful in

grasping.

Puts hands to bottle and pats it when feeding.

Shakes rattle deliberately to make it sound, often

regarding it closely at same time.

Still friendly with strangers but occasionally shows

some shyness or even slight anxiety, especially if

mother is out of sight.

9 MONTHS

Sits alone for 10–15 minutes on floor.

Can turn body to look sideways while stretching out

to grasp dangling toy or to pick up toy from floor.

Arms and legs very active in cot, pram and bath.

Progresses on floor by rolling or squirming.

Attempts to crawl on all fours.

Pulls self to stand with support.

Can stand holding on to support for a few

moments, but cannot lower himself.

Held standing, steps purposefully on alternate feet.

Very observant.

Stretches out, one hand leading, to grasp small

objects immediately on catching sight of them.

Manipulates objects with lively interest, passing

from hand to hand, turning over, etc.

Pokes at small sweet with index finger. Grasps

sweets, string, etc., between finger and thumb in

scissor fashion.

Can release toy by pressing against firm surface, but

cannot yet put down precisely.

Searches in correct place for toys dropped within

reach of hands.

Looks after toys falling over edge of pram or table.

Watches activities of adults, children and animals

within 10–12 feet with eager interest for several

seconds at a time.

(Watches rolling balls 21/8 inches at 10 feet.)

Vocalises deliberately as means of interpersonal

communication.

Shouts to attract attention, listens, then shouts

again.

Babbles tunefully, repeating syllables in long strings

(mam-man, bab-bab, dad-dad, etc.)

Understands ‘No-No’ and ‘Bye-Bye’.

Tries to imitate adults’ playful vocal sounds, eg.

smacking lips, cough, brr, etc.

(Immediate localising response to baby hearing tests

at 3 feet from ear and above and below ear level.)

Holds, bites and chews biscuits.

Puts hands round bottle or cup when feeding.

Tries to grasp spoon when being fed.

Throws body back and stiffens in annoyance or

resistance.

Clearly distinguishes strangers from familiars, and

requires reassurance before accepting their

advances.

Clings to known adult and hides face.

Still takes everything to mouth.

Seizes bell in one hand, imitates ringing action,

waving or banging it on table, pokes clapper or

‘drinks’ from bowl.

Plays peek-a-boo.

Holds out toy held in hand to adult, but cannot yet

give.

Finds partially hidden toy.

May find toy hidden under cup.

Mother supports at lower spine when dressing.

Chart illustrating the developmental progress of infants and young children – continued

25

Posture and large

movements

Vision and fine

movements

Hearing and speech

Social behaviour

and play

12 MONTHS

Sits well and for indefinite time.

Can rise to sitting position from lying down.

Crawls rapidly, usually on all fours.

Pulls to standing and lets himself down again

holding on to furniture.

Walks round furniture stepping sideways.

Walks with one or both hands held.

May stand alone for a few moments.

May walk alone.

Picks up small objects, eg blocks, string, sweets and

crumbs, with precise pincer grasp of thumb and

index finger.

Throws toys deliberately and watches them fall to

ground.

Looks in correct place for toys which roll out of

sight.

Points with index finger at objects he wants to

handle or which interest him.

Watches small toy pulled along floor across room

10 feet away.

Out of doors watches movements of people,

animals, motor cars, etc., with prolonged intent

regard.

Recognises familiars approaching from 20 feet or

more away.

Uses both hands freely, but may show preference

for one.

Clicks two bricks together in imitation.

(Watches rolling balls 21/8 inches at 10 feet.)

Knows and immediately turns to own name.

Babbles loudly, tunefully and incessantly.

Shows by suitable movements and behaviour that

he understands several words in usual context (eg.

own and family names, walk, dinner, pussy, cup,

spoon, ball, car).

Comprehends simple commands associated with

gesture (give it to daddy, come to mummy, say byebye,

clap hands, etc.)

Imitates adult’s playful vocalisations with gleeful

enthusiasm.

May hand examine common objects on request, eg.

spoon, cup, ball, shoe.

(Immediate response to baby tests at 3–41/2 feet but

rapidly habituates.)

Drinks from cup with little assistance. Chews.

Holds spoon but usually cannot use it alone.

Helps with dressing by holding out arm for sleeve

and foot for shoe.

Takes objects to mouth less often.

Puts wooden cubes in and out of cup or box.

Rattles spoon in cup in imitation.

Seizes bell by handle and rings briskly in imitation,

etc.

Listens with obvious pleasure to percussion sounds.

Repeats activities to reproduce effects.

Gives toys to adult on request and sometimes

spontaneously. Finds hidden toy quickly.

Likes to be constantly within sight and hearing of

adult.

Demonstrates affection to familiars.

Waves ‘bye-bye’ and claps hands in imitation or

spontaneously.

Child sits, or sometimes stands without support,

while mother dresses.

15 MONTHS

Walks unevenly with feet wide apart, arms slightly

flexed and held above head or at shoulder level to

balance.

Starts alone, but frequently stopped by falling or

bumping into furniture.

Lets himself down from standing to sitting by

collapsing backwards with bump, or occasionally by

falling forward on hands and then back to sitting.

Can get to feet alone.

Crawls upstairs.

Kneels unaided or with slight support on floor and in

pram, cot and bath.

May be able to stoop to pick up toys from floor.

Picks up string, small sweets and crumbs neatly

between thumb and finger.

Builds tower of two cubes after demonstration.

Grasps crayon and imitates scribble after

demonstration.

Looks with interest at pictures in book and pats

page.

Follows with eyes path of cube or small toy swept

vigorously from table.

Watches small toy pulled across floor up to 12 feet.

Points imperiously to objects he wishes to be given.

Stands at window and watches events outside

intently for several minutes.

(Watches and retrieves rolling balls of 21/8 inches at

10 feet.)

Jabbers loudly and freely, using wide range of

inflections and phonetic units.

Speaks 2–6 recognisable words and understands

many more.

Vocalises wishes and needs at table.

Points to familiar persons, animals, toys, etc., when

requested.

Understands and obeys simple commands (eg. shut

the door, give me the ball, get your shoes).

(Baby test 41/2–6 feet.)

Holds cup when adult gives and takes back.

Holds spoon, brings it to mouth and licks it, but

cannot prevent its turning over. Chews well.

Helps more constructively with dressing.

Indicates when he has wet pants.

Pushes large wheeled toy with handle on level

ground.

Seldom takes toy to mouth.

Repeatedly casts objects to floor in play or rejection,

usually without watching fall.

Physically restless and intensely curious.

Handles everything within reach.

Emotionally labile.

Closely dependent upon adult’s reassuring

presence.

Needs constant supervision to protect child from

dangers of extended exploration and exploitation of

environment.

Chart illustrating the developmental progress of infants and young children – continued

26

Posture and large

movements

Vision and fine

movements

Hearing and speech

Social behaviour

and play

18 MONTHS

Walks well with feet only slightly apart, starts and

stops safely.

Runs stifly upright, eyes fixed on ground 1–2 yards

ahead, but cannot continue to run round obstacles.

Pushes and pulls large toys, boxes, etc., round floor.

Can carry large doll or teddy-bear while walking

and sometimes two.

Backs into small chair or slides in sideways.

Climbs forward into adult’s chair then turns round

and sits.

Walks upstairs with helping hand.

Creeps backwards down stairs.

Occasionally bumps down a few steps on buttocks

facing forwards.

Picks up toy from floor without falling.

Picks up small sweets, beads, pins, threads, etc.,

immediately on sight, with delicate pincer grasp.

Spontaneous scribble when given crayon and paper,

using preferred hand.

Builds tower of three cubes after demonstration.

Enjoys simple picture book, often recognising and

putting finger on coloured items on page.

Turns pages 2 or 3 at a time.

Fixes eyes on a small dangling toy up to 10 feet.

(May tolerate this test with each eye separately.)

Points to distant interesting objects out of doors.

(Watches and retrieves rolling balls 2–1/2 inches at

10 feet.)

(Possibly recognises special miniature toys at 10

feet.)

Continues to jabber tunefully to himself at play.

Uses 6–20 recognisable words and understands

many more.

Echoes prominent or last word addressed to him.

Demands desired objects by pointing accompanied

by loud, urgent vocalisation or single words.

Enjoys nursery rhymes and tries to join in. Attempts

to sing.

Shows his own or doll’s hair, shoe, nose (Possibly

special 5 toy test. Possibly 4 animals picture test.)

Lifts and holds cup between both hands.

Drinks without spilling.

Hands cup back to adult. Choose well.

Holds spoon and gets food to mouth.

Takes off shoes, socks, hat.

Indicates toilet needs by restlessness and

vocalisation.

Bowel control usually attained.

Explores environment energetically.

No longer takes toys to mouth.

Remembers where objects belong.

Casts objects to floor in play or anger less often.

Briefly imitates simple activities, e.g. reading book,

kissing doll, brushing floor.

Plays contentedly alone, but likes to be near adult.

Emotionally still very dependent upon familiar adult,

especially mother.

Alternates between clinging and resistance.

2 YEARS

Runs safely on whole foot, stopping and starting

with ease and avoiding obstacles.

Squats to rest or to play with object on ground and

rises to feet without using hands.

Walks backwards pulling large toy.

Pulls wheeled toy by cord.

Climbs on furniture to look out of window or open

doors, etc., and can get down again.

Walks upstairs and down holding on to rail and wall;

two feet to a step.

Throws small ball without falling.

Walks into large ball when trying to kick it.

Sits astride large wheeled toy and propels forward

with feet on ground.

Picks up pins and thread, etc., neatly and quickly.

Removes paper wrapping from small sweet.

Builds lower of six cubes (or 6+).

Spontaneous circular scribble and dots when given

paper and pencil.

Imitates vertical line (and sometimes V).

Enjoys picture books, recognising fine details in

favourite pictures.

Turns pages singly.

Recognises familiar adults in photograph after once

shown.

Hand preference becoming evident.

(Immediately catches sight of, and names special

miniature toys at 10 feet distance. Will now usually

tolerate this test with each eye separately.)

(Watches and retrieves rolling balls 2 – 1/8 inches at

10 feet.)

Uses 50 or more recognisable words and

understands many more.

Puts 2 or more words together to form simple

sentences.

Refers to himself by name.

Talks to himself continually as he plays.

Echo(s) a almost constant, with one or more

stressed words repeated.

Constantly asking names of objects.

Joins in nursery rhymes and songs.

Shows correctly and repeats words for hair, hand,

feet, nose, eyes, mouth, shoe on request.

(6 toy test, 4 animals picture test.)

Lifts and drinks from cup and replaces on table.

Spoon-feeds without spilling.

Asks for food and drink. Chews competently.

Puts on hat and shoes.

Verbalises toilet needs in reasonable time.

Dry during day.

Turns door handles. Often runs outside to explore.

Follows mother round house and copies domestic

activities in simultaneous play.

Engages in simple make-believe activities.

Constantly demanding mother’s attention.

Clings lightly in affection, fatigue or fear.

Tantrums when frustrated but attention readily

distracted.

Defends own possessions with determination.

As yet no idea of sharing.

Plays near other children but not with them.

Resentful of attention shown to other children.

Chart illustrating the developmental progress of infants and young children – continued

27

Posture and large

movements

Vision and fine

movements

Hearing and speech

Social behaviour

and play

21/2 YEARS

Walks upstairs alone but downstairs holding rail,

two feet to a step.

Runs well straight forward and climbs easy nursery

apparatus.

Pushes and pulls large toys skillfully, but has

difficulty in steering them round obstacles.

Jumps with two feet together.

Can stand on tiptoe if shown.

Kicks large ball.

Sits on tricycle and steers with hands, but still

usually propels with feet on ground.

Picks up pins, threads, etc., with each eye covered

separately.

Builds tower of seven (or 7+) cubes and lines blocks

to form ‘train’.

Recognises minute details in picture books.

Imitates horizontal line and circle (also usually T and

V).

Paints strokes, dots and circular shapes on easel.

Recognises himself in photographs when once

shown.

Recognises miniature toys and retrieves balls 21/8

inches at 10 feet, each eye separately.

(May also match special single letter-cards V, O, T, H

at 10 feet.)

Uses 200 or more recognisable words but speech

shows numerous infantilisms.

Knows full name.

Talks intelligibly to himself at play concerning events

happening here and now.

Echolalia persists.

Continually asking questions beginning ‘What?’,

‘Where?’.

Uses pronouns, I, me and you.

Stuttering in eagerness common.

Says a few nursery rhymes.

Enjoys simple familiar stories read from picture

book.

(6 toy test, 4 animal picture test, 1st cube test. Full

doll vocabulary.)

Eats skilfully with spoon and may use fork.

Pulls down pants or knickers at toilet, but seldom

able to replace.

Dry through night if lifted.

Very active, restless and rebellious.

Throws violent tantrums and when thwarted or

unable to express urgent need and less easily

distracted.

Emotionally still very dependent upon adults.

Prolonged domestic make-believe play

(putting dolls to bed, washing clothes, driving

motor cars, etc.) but with frequent reference to

friendly adult.

Watches other children at play interestedly and

occasionally joins in for a few minutes, but little

notion of sharing playthings or adult’s attention.

3 YEARS

Walks alone upstairs with alternating feet and

downstairs with two feet to step.

Usually jumps from bottom step.

Climbs nursery apparatus with agility.

Can turn round obstacles and corners while running

and also while pushing and pulling large toys.

Rides tricycle and can turn wide corners on it.

Can walk on tiptoe.

Stands momentarily on one foot when shown.

Sits with feet crossed at ankles.

Picks up pins, threads, etc., with each eye covered

separately.

Builds tower of nine cubes, also (31/2 ) bridge of

three from model.

Can close fist and wiggle thumb in imitation.

R and L.

Copies circle (also V, H, T). Imitates cross.

Draws man with head and usually indication of

features or one other part.

Matches two or three primary colours

(usually red and yellow correct, but may confuse

blue and green).

Paints ‘pictures’ with large brush on easel.

Cuts with scissors.

(Recognises special miniature toys at 10 feet.

Performs single-letter vision test at 10 feet. Five

letters.)

Large intelligible vocabulary but speech still shows

many infantile phonetic substitutions. Gives full

name and sex, and (sometimes) age.

Uses plurals and pronouns.

Still talks to himself in long monologues mostly

concerned with the immediate present, including

make-believe activities.

Carries on simple conversations, and verbalises past

experiences.

Asks many questions beginning ‘What?’, ‘Where?’,

‘Who?’.

Listens eagerly to stories and demands favourites

over and over again.

Knows several nursery rhymes.

(7 toy test, 4 animals picture test. 1st or 2nd cube

test, 6 ‘high frequency’ word pictures.)

Eats with fork and spoon.

Washes hands, but needs supervision in drying.

Can pull pants and knickers down and up, but needs

help with buttons.

Dry through night.

General behaviour more amenable.

Affectionate and confiding.

Likes to help with adult’s activities in house and

garden.

Makes effort to keep his surroundings tidy.

Vividly realised make-believe play including

invented people and objects.

Enjoys floor play with bricks, boxes, toy trains and

cars, alone or with siblings.

Joins in play with other children in and outdoors.

Understands sharing playthings, sweets, etc.

Shows affection for younger siblings.

Shows some appreciation of past and present.

Chart illustrating the developmental progress of infants and young children – continued

28

Posture and large

movements

Vision and fine

movements

Hearing and speech

Social behaviour

and play

4 YEARS

Turns sharp corners running, pushing and pulling.

Walks alone up and downstairs, one foot per step.

Climbs ladders and trees.

Can run on tiptoe.

Expert rider of tricycle.

Hops on one foot.

Stands on one foot 3–5 seconds.

Arranges or picks up objects from floor by bending

from waist with knees extended.

Picks up pins, thread, crumbs, etc., with each eye

covered separately.

Builds tower of 10 or more cubes and several

‘bridges’ of three on request.

Builds three steps with six cubes after

demonstration.

Imitates spreading of hand and bringing thumb into

opposition with each finger in turn, R and L.

Copies cross (also V, H, T and O).

Draws man with head, legs, features, trunk and

(often) arms.

Draws very simple house.

Matches and names four primary colours correctly.

(Single-letter vision test at 10 feet, seven letters:

also near chart to bottom).

Speech completely intelligible.

Shows only a few infantile substitutions usually

k/t/th/f/s and r/l/w/y groups).

Gives connected account of recent events and

experiences.

Gives name, sex, home address and (usually) age.

Eternally asking questions ‘Why?‘ ‘When?’, ‘How?’

and meanings of words.

Listens to and tells long stories sometimes confusing

fact and fantasy.

(7 toy test, 1st picture vocabulary test, 2nd cube

test.

6 ‘high frequency’ word pictures.)

Eats skilfully with spoon and fork.

Washes and dries hands. Brushes teeth.

Can undress and dress except for back buttons,

laces and ties.

General behaviour markedly self-willed.

Inclined to verbal impertinence when wishes

crossed but can be affectionate and compliant.

Strongly dramatic play and dressing-up favoured.

Constructive out-of-doors building with any large

material to hand.

Needs other children to play with and is alternately

co-operative and aggressive with them as with

adults.

Understands taking turns.

Shows concern for younger siblings and sympathy

for playmates in distress.

Appreciates past, present and future.

5 YEARS

Runs lightly on toes.

Active and skilful in climbing, sliding, swinging,

digging and various ‘stunts’.

Skips on alternative feet.

Dances to music.

Can stand on one foot 8–10 seconds.

Can hop 2–3 yards forwards on each foot

separately.

Grips strongly with either hand.

Picks up minute objects when each eye is covered

separately.

Builds three steps with six cubes from model.

Copies square and triangle (also letters; V, T, H, O,

X, L, A, C, U, Y).

Writes a few letters spontaneously.

Draws recognisable man with head, trunk, legs,

arms and features.

Draws simple house with door, windows, roof and

chimney.

Counts fingers on one hand with index finger of

other.

Names four primary colours and matches 10 or 12

colours.

(Full nine-letter vision chart at 20 feet and near test

to bottom.)

Speech fluent and grammatical.

Articulation correct except for residual confusions of

s/f/th and r/l/w/y groups.

Loves stories and acts them out in detail later.

Gives full name, age and home address.

Gives age and (usually) birthday.

Defines concrete nouns by use.

Asks meaning of abstract words.

(12 ‘high frequency’ picture vocabulary or word

lists. 3rd cube test, 6 sentences.)

Uses knife and fork.

Washes and dries face and hands, but needs help

and supervision for rest.

Undresses and dresses alone.

General behaviour more sensible, controlled and

responsibly independent.

Domestic and dramatic play continued from day to

day.

Plans and builds constructively.

Floor games very complicated.

Chooses own friends.

Co-operative with companions and understands

need for rules and fair play.

Appreciates meaning of clock time in relation to

daily programme.

Tender and protective towards younger children

and pets. Comforts playmates in distress.

Chart illustrating the developmental progress of infants and young children – continued

Reprinted from Reports on Public Health and Medical SubjectsNo 102.

HMSO 1960, revised 1975. In Department of Health (1988) Protecting Children.

A Guide for Social Workers undertaking a Comprehensive Assessment, pp.88–93.

HMSO, London.

29

APPENDIX 2 Genogram

First child Second child Miscarriage or

abortion

Twins

Male Female Gender unknown

(e.g. pregnancy)

Death

Genogram symbols

Separation

Divorce

Enduring

relationship

(marriage or

cohabitation)

Transitory

relationship

Genogram symbols

A dotted line should be drawn around the people who currently live in the same house.

Compiling a genogram

A genogram of family tree covering three or more generations may be compiled using these

symbols. Other relatives in addition to parents and children can be involved in compiling the

genogram. More than one session may be needed if the exercise is used to discuss the family’s

history in detail and to enter significant dates and other information. Working on a genogram

also provides the practitioner with an opportunity to observe family relationships, for example

how open family members are with each other, how well they respond to each other’s needs,

how flexible they are and how much they know about each other.

30

APPENDIX 3 Ecomap

Educational

Psychologist

Club

organisation

School/

teacher Mother

Father

Hobbies

interests

Maternal

grandparents

Probation

Officer

Social

Worker

Schoolfriend

Sibling

Paternal

grandparents

Sibling

Pet(s) Extended

family

Neighbourhood

friend

Neighbourhood

friend

Adult

neighbour G.P.

Extended

family

CHILD

_ Place child or couple or family in central circle.

_ Identify important people or organisations and draw circles as needed

_ Draw lines between circles where connections exist

_ Use different types of lines to indicate the nature of the link or relationship

——– = strong

– – – – = weak

• • • • • = stressful

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Office, London.

Adcock M (1998) Significant harm: implications for local authorities. In Adcock M and

White R (eds) (1998) Significant Harm: its management and outcome. pp.33–56.

Significant Publications, Croydon.

Ahmed S, Cheetham J and Small J (ed) (1986) Social Work with Black Children and

their Families. Batsford Ltd, London.

Aldgate J and Bradley M (1999) Supporting Families through Short Term Fostering. The

Stationery Office, London.

Aldgate J and Simmonds J (eds) (1988) Direct Work with Children: a Guide for Social

Work Practitioners. Batsford, London.

Aldridge J and Becker S (1999) Children as carers: the impact of parental illness on

children’s caring roles. Journal of Family Therapy. 21: 303–320.

Amin K and Oppenheim C (1992) Poverty in Black and White: Deprivation in Ethnic

Minorities. Child Poverty Action Group, London.

Argyle M (1992) The Social Psychology of Everyday Life. Routledge, London.

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36

Introduction

2.1 The population of England is comprised of many white minority ethnic groups as well

as black minority ethnic groups and the differences in culture, religion, language and

traditions for white minority ethnic groups have to be accounted for just as they do for

black minority ethnic groups.

2.2 There are also a number of white minority ethnic groups who experience oppression

on the basis of their ethnic, cultural or religious identity. In assessing families these

experiences should be acknowledged and addressed.

2.3 This chapter focuses specifically on the needs of black children and families. Black

here refers to children and families of Asian, African and Caribbean origin including

children of dual heritage.

2.4 Whilst there are some similarities and parallels in the experiences of black and white

minorities in Britain there is also a fundamental difference. Institutional racism has

resulted in the significant impairment of the life opportunities of black people in this

country (MacPherson, 1999).

2.5 Institutional racism operates within the field of child welfare. Over the last thirty years

concern has been expressed about the number of black children in care (Batta,

McCulloch and Smith, 1979; Adams, 1981; Rowe et al, 1989; Barn, 1993; 1997), the

lack of take up of family support services (Butt and Box, 1998), and the lack of

potential for some black children (London Borough of Lambeth, 1997; The Bridge

Child Care Consultancy Services, 1991).

2.6 Assessing the developmental needs of children is a complex process which requires all

relevant aspects of a child’s life experience to be addressed. For black children

assessments should address the impact that racism has on a particular child and family

and ensure that the assessment process itself does not reinforce racism through racial

or cultural stereotyping.

2.7 This chapter aims to assist child welfare professionals in undertaking assessments of

black children in need and their families.

Assessing black children in need and their families

2.8 Within the current context of practice, professionals charged with responsibilities for

promoting the welfare of children and their families often struggle with how best to

37

2 Assessing black children in need and their

families

address the needs of black children and their families. Although many professionals

are aware that it is essential to take account of race and culture, and in particular to be

culturally sensitive in their practice, they are often at a loss to translate this into

practical terms. In assessing the developmental needs of black children and their

families practitioners should address two key questions:

_ What are the developmental needs of black children and their families, and in

what ways are these similar, and in what ways do they differ from the developmental

needs of white children and families?

_ How can these developmental needs be responded to in work with black children

and families?

2.9 Both black and white children require their parents or carers to respond to their same

fundamental care needs. They all need basic care, warmth, stimulation, guidance,

boundaries and stability. Any child who grows up without access to these basic life

blocks (as a result of poor parental care) will suffer to a greater or lesser extent.

2.10 The base lines for assessing parenting capacity and the child’s developmental needs

should be the same irrespective of whether a black or a white child is being assessed.

2.11 Later in this chapter, we look in detail at the similarities in and differences between the

needs of black children and their families compared with white children and their

families when using the Assessment Framework dimensions. Each of the three

domains of the Assessment Framework will be addressed with respect to each of its

dimensions.

2.12 Firstly, the context will be set for assessing black children and families. This includes

their demographic and socio-economic situation and the changing nature of culture,

as well as some key issues in professional practice.

Demography

2.13 According to the 1991 census the total black and minority ethnic population of

Britain is over 3 million people (5.5%). Of this 2.9 million black and minority ethnic

people live in England, 59.5 thousand live in Scotland and 40.5 thousand live in

Wales.

2.14 There are considerable regional variations in the ethnic composition of the population

with the largest composition being in London at 44.8% and West Midlands,

especially in Birmingham at 14% (Owen, 1992). Although there are regional

variations in ethnic composition of the population, there are few areas where black

people do not have a presence (Butt and Mirza, 1996).

2.15 One important feature of the black community is its relative youth compared to the

white community. For instance adults aged over 45 constitute 39% of the white

community compared to 18% of the black and minority ethnic community, and

adults aged over 65 account for 16.9% of the white community and only 3.2% of the

black and minority ethnic communities (Jones, 1993).

2.16 More importantly children under 15 constitute 33% of black and minority ethnic

communities compared to 19 % in the white communities. In certain parts of the

38

country such as the London Boroughs of Newham and Tower Hamlets children make

up the majority of the population. Other important features of the population include:

_ A very diverse black population with wide variations in class, countries of origin,

socio-economic conditions, religion and languages;

_ An increasing number of adult mixed relationships with 40% of African Caribbean

men and 20% of African Caribbean women in mixed relationships (Berrington,

1996; Haskey, 1997). Importantly, 80% of black adults in mixed relationships are

UK born and over half the children of mixed relationships are under the age of 15

(Haskey, 1997).

Socio economic conditions

2.17 Evidence suggests that many of Britain’s black population are experiencing economic

hardship. According to the Social Exclusion Unit (1998) ‘Ethnic minority groups are

more likely than the rest of the population to live in poor areas, be unemployed, have

low incomes, live in poor housing, have poor health and be the victims of crime’.

2.18 The important point about the socio-economic conditions of black communities

from an assessment perspective is, as Butt and Mirza (1998) observe ‘black

communities are at greater risk of experiencing some of the stress so often associated

with people who need the services of social care agencies’.

The changing nature of culture for England’s black population

2.19 The impact of social and economic forces, the effects of racism and racial harassment,

changing family structures, access to suitable housing, the interaction between

cultures, particularly in respect of children and young people and the experience of

growing up in England are amongst a number of factors which have led to the

changing nature of culture for black communities in this country. However, this has

not led to an erosion of culture, as has sometimes been portrayed, but to the

emergence of new cultural frameworks (Donald and Rattansi, 1992).

2.20 In some cases there has been a return to traditional values, exhibited by an increased

interest in religious observance; in others, particularly among teenagers, there has

been a mixing of cultures to create a street based culture strongly influenced by black,

and in particular, black American and Caribbean culture.

2.21 Dosanjh and Ghuman (1998) describe the cross-fertilisation of cultures as

‘enculturation’ meaning:

This dynamic of enculturation…can be summarised as comprising a continuity

with some traditional norms alongside the adopting of some of the norms of British

lifestyles.

2.22 Despite these significant changes, culture remains a central part of the lives of black

communities, for it is the primary way in which black communities can give meaning

and continuity to their own distinct identities, rites, traditions, values, beliefs and

customs. For many black people, it is their culture which gives them the strength to

survive in a hostile environment.

39

Key Issues in current child welfare practice

Numbers of black children in care

2.23 There are no current available figures on the number of black children in care in

England. There are a number of small scale and local studies which have indicated an

over-representation of black children in care particularly of dual heritage and African

Caribbean origin. Although there are difficulties in drawing conclusions from these

studies on a national basis, their findings cannot be ignored.

2.24 Local authorities should analyse their population of children looked after to ascertain

the extent to which the number of black children who are looked after reflects the local

profile of the black population. If there is an under or an over representation of black

children, the local authority should take active steps to identify the reasons for this

situation and address it.

Family Support

2.25 There is evidence also that black families are not gaining access to family support

services. In a study of black families’ use of family centres Butt and Box (1998) found

that 13 out of the 84 centres had no black and minority ethnic users and 25 centres

had black and minority ethnic users in equal proportion to their presence in the

population. The authors conclude:

Our study suggests that black communities do not always have access to family

centres and rarely access the full range of services that are available. This is not

merely an outcome of black families choosing which service they access (although

there is an element of that) but that the services only rarely get black families

through the front door and some black users appeared to be unaware of the range of

services that were available.

Inquiry Reports

2.26 At the same time, several Inquiry Reports into the deaths of black children provide

evidence of a lack of intervention in situations where black children were at obvious

risk of suffering significant harm from their parents. Two specific reports, Whose

Child? The Report of the Panel of Inquiry into the Death of Tyra Henry 1987 (London

Borough of Lambeth, 1987) and Sukina; An evaluation report of the circumstances

leading to her death (The Bridge Child Care Consultancy Services, 1991) make a direct

link between racism and the practice of professionals when responding to the children

and families concerned. Both reports identify that stereotyping of black families and a

reluctance on the part of white professionals to intervene for fear of being accused of

racism influenced practice.

2.27 It is clear that a more informed approach to the issue of race and culture within professional

assessments is required. The remainder of this chapter will discuss ways in

which professional practice could be developed to improve the assessment of and

planning for black children and their families through an evidence-based, systematic

and holistic approach to assessments with black families.

40

THEORIES AND PRACTICE INFORMING ASSESSMENT

Domain: Children’s Developmental Needs

Health

2.28 The following are some of the issues to be considered regarding health and black

children and families:

_ Research has shown the link between poverty and ill-health. Although this is as true

for the white community as it is for the black community there is evidence to

suggest that black and minority ethnic people experience poorer health. There are,

however, differences amongst the different ethnic groups. A study by Nazroo

(1997) found that on the whole Pakistanis and Bangladeshis reported the poorest

health during assessments of general health, with Caribbeans having the next worst

state of health;

_ There is a very strong correlation between the physical health of children of all ages

and adverse social and economic conditions. This is particularly apparent in the

infant mortality rate, which is directly affected by factors such as economic status,

type of accommodation, access to basic amenities and access to preventative and

supportive health care. A number of studies have shown a higher infant mortality

rate amongst poorer black communities, particularly within families from

Bangladesh, Pakistan and the Caribbean (Smaje, 1999);

_ There are some diseases which are more common amongst black and minority

ethnic people and some which are particular to black communities only. In relation

to the latter sickle cell disorder is one such illness, affecting mainly children from the

African Caribbean community but may occur in people from India and Pakistan.

For those affected by it, the most difficult aspect of the disorder is the pain

experienced during the crisis. Symptoms can include infections such as meningitis

as well as strokes (NHS Executive, 1998). Professionals working with black

children affected by sickle cell can get more information about the disorder from

the Sickle Cell Society;

_ Particular groups of children such as refugee children can suffer post-traumatic

stress syndrome. This can be directly attributed to the past experiences of many of

the children. They may have witnessed death, violence and war prior to their arrival

in the U.K.

_ Pointers for Practice

Assessments of black families should take account of the specific health needs of

different black communities and address:

The extent to which the physical health of the child may be affected by adverse

social conditions;

The extent to which the child and family have direct access to appropriate advice

support and services in relation to their health care needs;

41

Whether the child or family members may be likely to suffer from sickle cell disorder;

Whether past life experiences or trauma has had any affect on the physical health of

the child.

Education

2.29 From a psychological perspective, there is no difference in the cognitive or educational

capacity or development of black children as compared to white. However, in social

terms, there is no aspect of child development in which racism has had a greater

impact in this country than that of educational and cognitive development.

2.30 Today, whilst there is an acknowledgement that there is no biological or genetic

difference between black children’s intelligence or educational ability as compared to

white children, race continues to make a difference in the educational experience and

achievements of black children. There is a great deal of evidence to suggest that black

pupils in England under-achieve educationally and are more likely to be excluded

from school than their white counterparts:

_ The data on permanent school exclusions for 1996/97 show that African Caribbean

pupils are more than four times as likely to face permanent exclusions compared to

white pupils. Kundnani (1998) summaries evidence which suggests the ‘profile of

African Caribbean children who are excluded differs from that of excluded children

generally; they are usually higher than average ability, exhibit less evidence of deepseated

trauma and are less likely to have shown disruptive behaviour from early in

their school career’. Kundnani (1998) suggests that there is a problem ‘between

teachers and black children and that teachers’ perceptions of black children (and

vice versa) do, somehow play a crucial role’;

_ The over-representation of black children excluded from school has also been

identified as an important issue by the Social Exclusion Unit;

_ The most recent data on achievements in school show that African Caribbean,

Pakistani and Bangladeshi children continue to under-achieve;

_ Black parents consistently express concern about being undermined by the school

system.

_ Pointers for Practice

Assessment of black children’s educational and cognitive development should take

account of racism as it may manifest itself within the educational system and address:

_ Whether the child has had the opportunity to realise their educational potential

without the limitations imposed upon them by negative stereotyping;

_ For an excluded child, the extent to which the exclusion is appropriate in relation to

the child’s behaviour;

_ The extent to which the child’s parents are consulted about and involved in the

child’s education.

42

Identity and Emotional and Behavioural Development

2.31 Identity is important for all children: there are close links between the development of

a child’s identity and their emotional and behavioural development. Children who

have emotional and behavioural difficulties often have a poor self-image and low selfesteem.

2.32 There is still considerable misunderstanding about the nature of identity and its

central importance to all children. One of the reasons for this, is that identity is most

often spoken about in relation to black children in situations where the child is

perceived to be exhibiting identity problems. In fact, many children about whom

there are professional concerns have problems with their identity, self-esteem and selfworth.

These issues have been shown to be particularly significant for many children

in the care system, both black and white. In their recent study of the effectiveness of

care in childrens homes, Sinclair and Gibbs (1998) found that over 70% of children

and young people had low self-esteem.

The nature of Identity

2.33 Identity is difficult to define, yet it is central to every person’s sense of their own

individuality and place in society. Definitions range from spiritual or religious,

through to psychodynamic, behavioural, social and structural interpretations. We will

draw on the literature to propose a model of understanding identity in relation to

black children and their families which is inclusive of all the elements of which it is

comprised.

2.34 Within most societies, identity fulfils two useful functions. It allows individuals to

understand and conceptualise themselves as distinct from others and it allows

individuals to form group identities with other individuals who have similar characteristics

to their own.

Group identification

2.35 Group identification allows individuals to categorise each other in social interactions.

Race, gender, class, disability, age, sexual identity, are all features of group identity

which have an outcome for group members in terms of institutional discrimination

and disadvantage. For black children and their families, being black in a white society

is not just about personal or group identity, it is about a lived experience of discrimination

on the grounds of colour and physical characteristics.

2.36 For children and young people who are both black and disabled, the experience of

discrimination on the basis of their disability is compounded by the effects of racism.

Despite this, many black and disabled children find that only one aspect of their

experience is addressed at any one time.

Individual and personal identity

2.37 Individual identity is the internal model which allows each person to have a

perception of themselves as an individual and social being. We are all members of

numerous social groupings, but we are also distinct in our own individuality from any

other member of a given group to which we belong, despite some areas of

commonality (See Erikson, 1968).

43

2.38 There is a complex interaction which takes place between the elements of one’s

personality to form an individual identity. Although each child is born with a specific

genetic blueprint, inherited from their parents, each is unique. This is because each

individual interaction between a child, his or her family, relationships, social context

and environment, will be processed into an individual experience. These sets of

individual experiences contribute towards the development of a whole personality.

2.39 Identity, therefore, has to be defined and assessed in terms of a holistic model of

children’s development which incorporates other facets of his or her developmental

needs. The diagram below sets out how these key elements interact to form a child’s

identity (Figure 4).

2.40 From the time a child is born, he or she begins to develop an individual identity. First

interactions with their carers, siblings and social contacts become part of the child’s

internal model of identity. These experiences also locate the child within a social world

in which group identities begin to influence identity formation.

2.41 For black children and their families, racism affects both individual and group

identities. Although there is no biological or genetic basis for the concept of a racial

group, race has a social significance in that it affects the way in which a child him or

herself and is perceived by others. A black child growing up within a predominantly

white society will receive negative messages about being black, and needs a positive

internal model of black identity to counteract negative stereotypes. A black child who

is also disabled will be affected by their own and others perception of both their

disability and their race, and will need to be given the opportunity to develop a

positive sense of themselves which helps them to counteract negative messages about

both.

The Development of a racial identity

2.42 Racial identity is relevant to all children whether black or white. Being white is a racial

identity, just as being black is one. However, because being white in England is often

perceived as normative, being black becomes defined in terms of its difference to white

norms. In fact, all children go through a developmental process of acquiring a racial

identity, although many white adults and children along with a percentage of black

adults and children are not aware they are doing so. Black children do not universally

acquire a negative sense of self despite the effects of racism (Milner, 1983; Owusu-

Bempah and Howitt, 1999).

2.43 The preconditions for identity formation for a secure black child growing up in a

loving environment with racially aware black carers will be very different to the

preconditions for a black child who has an insecure base, a poor caregiving

environment and unaware or even hostile black or white carers.

2.44 For black children who do not have a positive sense of their racial identity, Cross

(1971) provides one model for understanding and assessing racial identity. He

explains the acquisition of their racial identity in terms of a five stage process:

_ Pre-encounter stage

This is before a child’s has encountered racism, where their world view is influenced

by a white perspective.

44

45

Figure 4 A model of identity

PHYSICAL DEVELOPMENT

Health

Physical development

Physical appearance

GROUP IDENTITY

Ethnicity

Culture Religion Language

Class

Gender Sexual identity

Disabled Non-disabled

——————————————

INDIVIDUAL IDENTITY

Personal self-definition

EMOTIONAL

DEVELOPMENT

Emotional maturity

Attachments

Relationships

SOCIAL

DEVELOPMENT

Social awareness

Social presentation

Social skills

Social responsibility

SELF-ESTEEM

Pride

Self-concept

Self-confidence

BEHAVIOURAL

DEVELOPMENT

Behaviour patterns

Positive behaviour

Negative behaviour

EDUCATIONAL

DEVELOPMENT

Intellectual

Cognitive

Educational attainment

FAMILY AND SOCIAL

COMMUNITY

AND

ENVIRONMENT

FAMILY AND SOCIAL

FAMILY AND

SOCIAL

RELATIONSHIPS

_ Encounter stage

This coincides with the child’s first real encounter with racism. The significance of

this experience forces the child to reconsider their previous world view and to

reinterpret their experiences.

_ Immersion-emersion stage

This is where the child seeks to reject all previous aspects of their identity, and to

become immersed in their blackness. However, this is only a superficial and reactive

concept of black identity, which is more connected with the semblance of

blackness, than with an integrated working model of a black identity. Individuals at

this stage are often, wrongly perceived to have a positive black identity.

_ Internalisation stage

This is a move towards a more positive and integrated model of identity, in which an

internal working model of black identity begins to take shape.

_ Internalisation-commitment stage

This is where the internal model links to aspects of a group identity, in that the child

commits themselves to active participation in and commitment to the black

community.

2.45 Cross’ model also helps provide some insight into the links between personal racial

identity and racial group identification. It helps us to understand the connections

between personal racial identity, racial group identification and emotional and

behavioural development. For instance a black person who group identifies as black,

but is unable to internalise that identification will show in the way they behave the

disconnections between their external and internal worlds. Similarly, a black child

who has an integrated sense of their racial identity will exhibit this in their interactions

and relationships with others.

2.46 For black children with one white parent (children of dual heritage) the connections

between personal self-definition and group identification can hold particular significance.

Although a number of recent studies have focused on the identity of children

of dual heritage (Banks, 1992; Tizard and Phoenix, 1994; Katz, 1996), it should be

stressed that these children should not be pathologised as having identity problems or

identity conflicts. Many children of dual heritage have a very positive and integrated

racial identity.

2.47 However, for some children of dual heritage, the dynamics of racial group identification

are very complex. It is often stated that such children “want to be white” or are

“denying their blackness”. This is an over-simplification of their position.

2.48 For some of these children, particularly those who live with their white parent and

have little or no contact with their black parent or the black parent’s family, black selfdefinition

means more than a journey towards self-recognition. For them there are

emotional consequences to black racial group identification. If they perceive their

white parent as caring and supportive, they may not wish to hurt a loved person by

rejecting the white racial identity of their main carer, or white people in their main

caregiving environment.

2.49 For these children it is important to understand the context in which the process of

identity development is taking place. Working with these children and their white

46

carers to strengthen the child’s internal working model of racial identity is crucial to

helping them feel positive about their racial identity and to deal with the racism which

they will inevitably experience.

2.50 Whilst Cross’ model was developed to help understand black racial identity, it is also

applicable to the assessment of white racial identity. Just as the acquisition of an

integrated sense of self in relation to race is a process for black people, so it is for white

people. White children’s attitudes to race reflect this. In their study of mainly white

primary schools Troyna and Hatcher (1992) found that white children exhibited

inconsistent attitudes towards race, ranging from overtly racist frameworks of

interpretation through to well developed notions of race equality.

2.51 An interesting aspect of their research findings is the inconsistency between expressed

values and behaviour:

…a number of combinations of attitudes is possible, ranging from children who

hold overtly racist beliefs but do not express them in behaviour, to children who

hold racially egalitarian beliefs but use racist name calling in certain situations.

2.52 This demonstrates the need for dialogue about race and racism with white children

and young people, as a way of exploring and integrating their notions of race. An

awareness of the impact of racism and an understanding of their white cultural

heritage are also important parts of positive identity development for white children

in a multi-racial and multi-cultural society.

Ethnicity

2.53 Whilst race is defined by heritage, colour, physical appearance, and physical characteristics,

ethnicity is defined by geographic, political, historical, religious and cultural

factors. Cashmore (1984) describes an ethnic group as:

a group possessing some degree of coherence and solidarity composed of people

who are, at least latently aware of having common origins and interests.

2.54 There are white ethnic groups as well as black ethnic groups. Minority status is related

simply to being in the minority within a given population. Both black and white

people continue to be oppressed and discriminated against on the basis of their

ethnicity.

2.55 As an aspect of individual and group identity, ethnicity is significant in that it gives

individuals a sense of community, heritage and belonging. Ethnicity, like race, cannot

be acquired through lifestyle or association. As such, ethnicity is an important aspect

of identity in both individual and group terms.

2.56 For children, the acquisition of an ethnic identity is an important process which helps

them to connect their personal and family history to that of a community or social

grouping. As such it gives them a sense of heritage.

Cultural, religious and linguistic identity

2.57 Culture, religion and language are three distinct parts of identity which interconnect

with racial and ethnic identity. However, they are distinct from both in that they can

be acquired through the process of socialisation. A child can be born into a family

47

from one cultural background, speak one language and be brought up with a

particular set of religious beliefs. With a change of lifestyle, a new parental

partnership, or a geographical move some or all of these aspects of the child’s life may

change, whilst their racial and ethnic identity remain the same.

2.58 However, culture, religion and language are very important aspects of group and

individual identity. Whilst racial identity forms one important aspect of identity,

individuals from the same racial group may have differences in terms of their cultural

background, religious observance and linguistic identity.

Culture

2.59 Much has been written about the concept of culture. We will not revisit old ground,

but will summarise the following key points which are crucial to an understanding of

the nature of culture and acquiring a cultural identity.

_ Both black and white people have cultural identities;

_ Culture is dynamic, not monolithic;

_ Culture is acquired through live experiences;

_ Culture is not static, but changes and develops over time;

_ There are differences between families who have the same cultural background;

_ Views of black cultures are influenced by cultural and racial stereotyping.

The acquisition of cultural identity

2.60 Just as for racial identity, cultural identity functions at both a group and an individual

level. It is acquired from live experiences. From birth, the child’s senses are attuned to

the specifics of their environment:

Individuation begins with the environment and evolves largely through sensory

and perceptual experiences (Prohansky and Gottlieb, 1989).

2.61 The particular music young children hear, the language spoken or type of regional

accent or dialect, the colours of clothing and fabrics seen, distinct household and

cooking smells all provide a particular and distinct environment which contributes

towards the formation of their cultural identity.

2.62 As a child grows older, interacts more with their family, community and the world at

large, these interactions become more complex and multi-faceted. At the same time as

developing capabilities for self-reflection and self-definition, the child acquires an

individual cultural identity which has been shaped both by the particular context in

which it has been developed and the child’s own contribution to the process.

2.63 During this developmental process, the child will act and react in relation to a host of

cultural information. Some of this will be specific to their own family traditions, some

will be shared with individuals and families who come from a similar cultural

background to the child. Through these interactions the child learns about individual

family values and norms as well as about those norms and values which may be shared

as group values.

48

2.64 For black disabled children there may also be other cultural connections which are

important to them in addition to their family connections. For example, a black child

who is deaf will also have experiences of deaf culture, where they may share commonalities

with children and young people who have different ethnicities and family

backgrounds to themselves. Whilst these commonalities will influence aspects of

group-identification with other deaf children and young people, family culture will

also be significant in defining identity. In this way, the acquisition of cultural identity

can only be understood by taking account of the whole experience of each child or

young person.

2.65 For some children, who do not grow up in an environment where they experience

their own culture, perhaps because of being in substitute care, or because they do not

have contact with any black family members, the acquisition of cultural identity is a

more difficult process. For some of these children the only access to such experiences is

through books or television programmes.

2.66 These sources of information can provide the child with information about cultural

practices and traditions, but they cannot provide the child with a live and interactive

experience in which the child has the opportunity to participate in and even shape

events. Although useful if used appropriately, such information can also reinforce

stereotypical and monolithic notions of culture because of its essentially static nature.

Religion

2.67 Section 22(5)(c) of the Children Act 1989, requires local authorities to:

give due consideration to… the child’s religious persuasion…

2.68 There is some evidence to suggest that information about the child’s or family’s

religion is not always recorded in case files. Unpublished research undertaken by the

authors in a city and county authority indicate that religion was not routinely

recorded for black children.

2.69 Religion or spirituality is an issue for all families whether white or black. A family who

do not practise a religion, or who are agnostic or atheists, may still have particular

views about the spiritual upbringing and welfare of their children. For families where

religion plays an important role in their lives, the significance of their religion will also

be a vital part of their cultural traditions and beliefs (see CCETSW (1996) for a

helpful training pack on Spirituality and Religion).

2.70 In research undertaken by Carl Hylton for the Moyenda Project in 1997, an issue that

emerged strongly was the importance of spirituality as a survival strategy for black

families living in England. The report says:

It is our intention to register strongly the concept of spirituality that came from all

the respondents interviewed. Here, we are not particularly referring to religious

adherence that forms a major aspect of the lives of many visual minority people.

Spirituality as used here refers to wider feelings that include religious adherence, but

is also concerned with a particular way of life encompassing strength, perseverance,

forgiveness and the ability to build and concentrate on self-knowledge without

posing the destruction of other ethnic groups.

49

Language

2.71 The acquisition of language is central to any child’s development. It is also a feature of

the child’s individual and group identity. The particular language, dialect or accent

which the child learns and speaks will help them to define themselves, and others to

define the child in relation to themselves.

2.72 For children and adults, language represents more than the ability to communicate. It

also helps a child to access and be accessed by groups of people who share the same

language, and to reinforce the child’s sense of their own cultural group identity.

2.73 Dosanjh and Ghuman (1998) in their Study of Child-rearing Practices of Two

Generations of Punjabis found that the mothers were keen to maintain religious rites

and customs:

Likewise, they are eager to teach their children their mother tongue, despite the lack

of support from infant and primary schools.

2.74 It is vital that children have the opportunity to learn and maintain family languages.

Although actual figures are not available, many children placed in long term substitute

care have little or no opportunity to practise and develop their language skills apart

from speaking English. For these children there can be no more poignant reminder of

the loss of opportunity than the inability to communicate with other members of their

own family and community in their own language.

2.75 This opportunity is particularly important for disabled children whose acquisition of

language may be affected by their impairment.

Social Presentation and Selfcare Skills

2.76 A child’s social presentation and selfcare skills will reflect their own personal identity,

their group affiliations and their upbringing and environment.

2.77 One of the indicators that a black child has an integrated sense of self as a black person

is that they can define themselves in terms of their racial and cultural identity, as well

as being self-confident about their physical appearance and characteristics.

2.78 However, some children do not grow up with any access to other black people. These

children do not have the opportunity to naturally gain that support, strength and

guidance in their everyday contact with black people.

2.79 For some black children who live with a black and a white parent their home is a very

difficult environment in which to acquire a positive racial and cultural identity,

because they experience racism from within their home or family. Some of these

children internalise these negative feelings, and have very low self-esteem, whilst

others may externalise their negative experiences into various forms of anti-social

behaviour.

50

51

_ Pointers for Practice

Identity allows individuals to understand and conceptualise themselves as distinct from

others and allows individuals to form group identities with other individuals who have

similar characteristics to their own. Race, culture, religion and language are central to

group and individual identity. Assessments should to address identity holistically by

considering:

Any difficulties which the child may be having in acquiring a positive racial identity,

and what help the child requires to enable them do so;

The child’s awareness of their own ethnicity and personal, family and community

history. Where this is not available, what steps can be taken to obtain such

information;

The child’s access to a lived experience of their culture, for example, attendance at a

wedding, or participation in celebrations which include music, food and traditional

rituals will give a child a far more profound and effective sense of their cultural

identity than any amount of visual or written material;

The religious and spiritual needs of black children and their families – this will require

professionals to discuss the family’s belief systems religion, rites and traditions and

record them routinely;

The identity of disabled black children holistically and not as a hierarchy of need, in

that being black gives the child a specific perspective on their disability;

The extent to which the child has the opportunity to learn about and maintain family

languages. Where the child has not had this opportunity, what steps can be taken to

address this deficiency;

The extent to which a black disabled child has the opportunity to learn their first

language. As some disabled children rely upon other forms of communication apart

from the written or spoken word, it is vital that communication with their families is

facilitated in a way that accounts for their own modes of communication as well as

the family’s first language. For example, the basis of British Sign Language is English.

Translating BSL into English will facilitate the understanding of English speakers, but

for those who speak other languages, further translation is required. Although the

provision of interpreters is seen sometimes as a logistical nightmare for social welfare

agencies, the ability to communicate and to be understood has to be promoted as a

basic human right, without which any attempt at assessment would be impossible.

Family and Social Relationships

2.80 Family and social relationships are central to all children’s lives, whether they are black

or white. For both white and black children their early experiences of parenting and

social relationships can construct a blueprint for later social interactions.

2.81 When assessing parenting capacity and social relationships, practitioners often raise

questions about the extent to which eurocentric models of child development are

relevant to black families. Some think that using eurocentric theories such as

attachment is not appropriate to the assessment of black families.

2.82 Attachments are central to all human societies, and there are no differences between

black and white families in terms of the need for adults and children to form strong

and positive relationships.

2.83 Children in all communities depend upon the specific care and attention of at least

one significant adult who is able and willing to respond to the child’s needs for both

physical and emotional care. Children are vulnerable, particularly in their early years,

and attachment to a significant adult fulfils a basic function to ensure their survival

and wellbeing.

2.84 In the western world these parent-child relationships are explained by the theory of

attachment, but in the popular culture of all societies the central importance of loving

and protective relationships is represented in stories, folklore, poetry and music.

2.85 There is no difference in the preconditions for the formation of good attachments

between black and white families. In both cases, attachments develop out of a

relationship which is worked at by both baby and adult over a time. This relationship

requires the participation of both parties, in that secure attachments are

formed out of reciprocal relationships, in which there is a high degree of communication,

matched responsiveness and consistency (Klaus and Kennel, 1976; Bowlby,

1988).

2.86 The third area of similarity is the importance of attachment to the internal working

model which forms the basis for developing children’s self-esteem, self-confidence and

self-perception, as well as acting as a model for future social relationships and

interactions (Bowlby, 1973). The theory is that through the care, responsiveness and

affection that children receive from their attachment figures, they learn to see

themselves as valued people who have a right to care and affection and who have selfworth.

Children who grow up in environments where adult carers are not responsive

to their needs, and are not caring or affectionate do not learn to see themselves as

worthy of such love, and adapt their behaviour accordingly.

2.87 The basic concepts on which attachment theory is based are clearly applicable to all

human relationships, and are important to our understanding of the human

condition. However, there are aspects of attachment theory that require more

discussion in relation to their applicability to black families.

2.88 The first of these is in relation to the identity of attachment figures. Much of the

literature on attachment emphasises the importance of either the mother (Bowlby,

1969) and/or parents (Schaffer and Emerson, 1964; Rutter, 1972) as the main

attachment figure for a child. It is here that there may be differences for some black

families. Differences to family structures, communities and networks will play an

important role in determining who the child will form key attachments with.

2.89 For many black families, family structures and interactions between family members

are very different in nature and character to those of white nuclear families. Within

this context a child may have strong attachments with a number of family members

and adults who are not blood relatives of the family. Thomas (1995) refers to this as

‘multiple attachments’. He says:

Friends and colleagues have talked about their experiences of being raised in

52

Bangladesh, Northern India and the Caribbean. They have talked about different

cultural experiences of attachment. These have been varied, from having multiple

mothering by grandmothers, mothers, aunts…This behaviour is thought to enable

the small child to establish strong bonds with the extended family or clan which will

be important for his or her future socialisation or welfare.

2.90 For many black families living in England, wider family networks and connections are

important not just to the individual family, but to the survival of the whole

community.

2.91 Social and economic circumstances have led to long term adult-child separations as a

result of migration. Arnold (1975) highlighted particular issues of loss and separation

for children who were parted from their parents as a result of migration to England,

and the subsequent effects on attachments and relationships when family members

were reunited having had little or no contact during the intervening years.

The earlier the separation between mother and child in the Caribbean, the more

problematic it became to re-establish bonds in the UK.

2.92 The impact of separation and loss is particularly acute for unaccompanied children

and young people who are seeking asylum in this country. For these children, the

losses, separations and traumas which they have experienced need to be understood

within the context of attachments, separations and losses.

These children have inevitably experienced significant disruption to their normal

lives. All, whatever, their social background, will have suffered the trauma of

losing familiar social landmarks, status and expectations (Social Services

Inspectorate et al, 1995).

2.93 In such circumstances the existence of any family networks and connections are vital

to the continued survival of individuals and communities. Owusu-Bempah and

Howitt (1997) highlight the importance these connections have for children, citing

the theory of socio-genealogical connectedness as a useful adjunct to attachment

theory in understanding the nature of children’s individual and group identities.

The notion of socio-genealogical connectedness refers to the extent to which

children identify with their natural parents’ biological and social background. A

basic tenet of this theory is that the degree to which children identify with their

natural parent’s backgrounds is dependent upon the amount and quality of

information that they possess about their parents.

2.94 This echoes an earlier premise in this chapter, namely that children require positive

information about their personal history and heritage in order to develop a sense of

personal and group identity. For many black people, this connectedness also extends

beyond individual families and into communities. Owusu-Bempah and Howitt

(1997) explain:

In a small-scale collective community where linkage may be with the whole group

rather than to one’s individual family, the information needed to achieve a sense of

connectedness is readily available throughout the community, the child’s sense of

continuity is provided by the whole community rather than the individual parent of

family.

53

_ Pointers for Practice

Information about family history and cultural heritage are vital not only to the child’s

sense of personal identity and wellbeing, but also to their sense of group identification.

In assessing the child’s relationships it is important to consider:

The child’s relationships within the context of their wider social networks and

connections;

The extent of quality and quantity of information the child has about their own roots

and heritage, and how deficiencies in this information can be addressed;

The specific family structure in which the child lives, and the patterns of attachment

which operate within this particular black family including any attachment figures

who may not be blood relatives;

The impact of migration, separation and trauma on the child and wider family

network.

Domain: Parenting Capacity

Basic Care

2.95 As stated earlier in this chapter, there are no differences in the basic care needs of black

children compared to white children. For all children, their healthy development

requires that basic care needs are responded to appropriately by the child’s main

caregivers.

Ensuring Safety

2.96 Both black and white children have the same right and the same need to be protected

from abuse, whether by acts of commission or omission. However, evidence cited at

the beginning of this chapter, indicates that race plays a part in the protection of black

children.

2.97 Whilst research studies have indicated that there is an over-representation of black

children within the care system (see paragraph 2.23), there is also evidence that some

black children are not being protected out of a fear on the part of white workers of

being accused of racist practice.

2.98 Whose Child? The Report of the Panel of Inquiry into the death of Tyra Henry 1987

(London Borough of Lambeth, 1987), a black child, suggested that the lack of support

provided by the Social Services Department to help the child’s grandmother care for

her was influenced by gender based racial stereotyping. An over-idealised view of

African-Caribbean women was cited as influencing social work practice with the

family. As a result of this lack of support, Tyra returned home to her parents where she

was subsequently killed by her step-father.

There is a “positive”, but nevertheless false stereotype in white British society of the

Afro-Caribbean mother figure as endlessly resourceful … essentially unsinkable. It

may have been an unarticulated and unconscious sense that a woman like Beatrice

54

Henry would find a way to cope no matter what, that underlay the neglect of social

services to make adequate provision for her taking responsibility for Tyra (London

Borough of Lambeth, 1987).

2.99 In the case of Sukina Hammond, a child of mixed parentage who was killed by her

father, the report of the circumstances leading to her death (The Bridge Child Care

Consultancy, 1991) states:

We know that agencies that are moving towards trying to be more sensitive and

understanding to the racial and cultural needs of their client group, do risk failing to

recognise the particular needs of an individual child. In addition, white professionals

who have undergone anti-racist training can sometimes over-compensate

out of fear of being accused of racism.

2.100 Studies (see Finkelhor, 1986; Jones and McCurdy, 1992) have shown little difference

in rates of physical abuse, sexual abuse and neglect across different ethnic and racial

groups. Despite this, there is evidence of differences in referral rates in relation to

specific types of abuse for particular black ethnic groups.

2.101 In their study, Operating the child protection system, Gibbons, Conroy and Bell (1995)

state that Black and Asian families were over-represented among referrals for physical

injury (58% versus 42%) and under-represented referrals for sexual abuse (20% versus

31%) compared to white families. They conclude that:

This illustrates cultural differences in child rearing and the difficulty of deciding

what forms of physical punishment are “acceptable” in Britain.

2.102 Thoburn et al (1995) echo this concern in their research on family involvement in the

child protection process:

Disagreements about the appropriateness of physical punishment features in a

disproportionate number of cases involving black families.

2.103 Farmer and Owen (1995) also refer to this dilemma in Private Risks and Public

Remedies:

In spite of (or perhaps because of ) considerable sensitivity in their perceptions, a

few workers were somewhat overwhelmed by the number of factors which appeared

to be relevant in minority ethnic cases and they had difficulty in combining them,

especially if culture, race and ethnicity were seen not as the total context for

intervention but to be added at the end of a lengthening list.

2.104 It is evident that race features at every stage of intervention, from the point of referral

onwards. An example of this is the differential referral rate for black families in relation

to physical injury and sexual abuse in Gibbons, Conroy and Bell’s study. The referral

rate is not illustrative of the actual incidence of abuse within a given community, but

it is indicative of which cases are referred to statutory agencies. It is erroneous to

assume that there is less sexual abuse within the black community, as this perpetuates

myths which results in sexual abuse being unrecognised and undetected within black

communities.

2.105 It is equally inaccurate to assume that the referral rates for physical injury of children

are based on different levels of physical chastisement within black communities, and it

perpetuates another myth that physical abuse is cultural within black communities.

55

2.106 Whilst physical injury and physical punishment are often discussed as

interchangeable terms there is a distinction between physically injuring a child and

using forms of physical disciplines – such as smacking.

2.107 Within current debates on parenting the acceptability of smacking is a hotly debated

topic. There are very different views held by parents about this both within and across

cultural boundaries. Just as many black families may strongly support the use of

smacking as a form of discipline so do many white families. Equally there are black as

well as white families who are strongly opposed to smacking children.

2.108 Physical injury to children occurs in black families just as it does within white families,

but it is not more or less a part of black culture than of white culture. Physical abuse is

unacceptable whatever the context. If physical abuse was a part of black culture then

all black children would be unsafe within black communities.

2.109 When a child is abused in a family, it is important to establish the circumstances

in which the abuse took place, as a means of targeting areas for intervention to

change patterns of behaviour. If it is assumed that the abuse occurs as a result of

cultural patterns of behaviour, then the focus for intervention may be the culture

itself.

2.110 Culture does not explain abuse. A parent who has injured a child may say “It is my

culture to punish my child in this way”. However, this does not explain why many

other parents from the same culture do not punish their child using this level of

physical chastisement, and some parents from the same culture use no physical

punishment at all.

2.111 Culture can explain the context in which abuse takes place, it can explain the values,

beliefs or attitudes of a parent at the time when an abusive incident took place, but it

cannot provide an explanation for the parent’s action in response to those values,

beliefs or attitudes.

_ Pointers for Practice

Issues of race and culture cannot simply be added to a list for separate consideration

during an assessment. They are integral to the assessment process. In undertaking

assessments of black families professionals should be mindful that:

From referral through to core assessment, intervention and planning, race and

culture have to be addressed using the Assessment Framework;

Culture can explain the context in which an abusive incident took place, but not the

behaviour or action of an individual parent. For example, a parent who injures their

child with a belt may say that this form of punishment is “cultural”. Their cultural

context may explain the parents anger within the expectations that he or she has of

the child, but will not explain why the parent acted upon this anger by using a belt to

hit the child. Other parents from the same culture in a similar context may choose to

punish the child without recourse to any physical punishment at all;

Racial and cultural stereotyping of black families can led to inappropriate

interventions in families as well as a failure to protect black children from abuse.

56

Racial abuse and harassment

2.112 An area of abuse of black children, not generally addressed by the social work

profession, is racial abuse and harassment. According to Dutt and Phillips (1996):

Racial abuse and harassment on the whole received a ‘no-reaction’ response from

social work professionals. Although many social services departments have

developed policies on racial attacks and harassment, there is little evidence to

suggest that the issue of racial abuse is a priority for departments or that practice is

beginning to take into account the reality of racial abuse.

2.113 A review of research on racism and racial abuse undertaken by the NSPCC (Barter,

1999) highlighted a dearth of research on racial abuse of children and young people. It

identified some important issues in this area namely:

_ Racism and racial bullying are commonplace in the lives of minority ethnic

children and young people, and in the lives of white children who will frequently

witness racial bullying as bystanders;

_ Studies focusing on racial bullying show that, compared to overall bullying figures,

children from ethnic minorities are more likely to experience bullying than their

white counterparts;

_ The most common expression of racism is through racist name-calling, which

research shows is often viewed by adults as trivial, although studies indicate that its

impact on children can be profound;

_ Although research evidence is limited, that available suggests racial bullying

frequently involves the use of violence.

2.114 Although this review highlights the lack of material on the racial abuse and its impact

on black disabled children, it quotes some studies specifically looking at racial abuse

and black disabled people. One example is a small study undertaken by Begum (1992)

on Asian disabled people and their carers. Her study shows that ‘overall about half of the

total sample reported that they had experienced racial harassment. Half of the disabled

people had experienced some form of verbal abuse, and 14% reported racial violence’.

2.115 Whatever form racial abuse takes, the impact of the abuse is devastating for the

child/young person, as well as for their family. The Childline study (1996) Children

and Racism highlights some of the impact of racial abuse on children. The study states

that ‘racist bullying causes real suffering, effects children’s self-esteem and confidence

and renders some children and young people so despondent that they feel suicidal and

attempt suicide’. The report concludes ‘youngsters cannot deal with bullying on their

own, they need adult help’.

2.116 Racial abuse may be a feature of the lives of black children of dual heritage living in

predominantly white families. In their study of race and racism in the lives of young

people of mixed heritage, Tizzard and Phoenix (1994) found that half the young

people in the sample ‘perceived either a parent or a sibling as being to some degree

racially prejudiced’.

2.117 The Childline study also highlighted racism experienced by children in their own

families. Comments from children calling Childline include:

57

Mum has left because dad was hitting her. Now he’s hitting me and calling me

‘half-breed’ and ‘nigger’ because my mum is black.

I am black and my mum is white…she has a new boyfriend who is completely racist…

He is not nice to me. When we are alone…He says things like “you need a bath”. This

12 year old girl felt she could not tell her mother because she wouldn’t believe her.

2.118 The Childline report concludes that ‘perhaps the most unhappy children we hear

from are those where racism is part of their family life. They are being excluded or

abused by the people they love’.

_ Pointers for Practice

Racial abuse damages children both physically and emotionally and as such warrants

professional intervention to address the effects of this form of abuse whether it comes

from within or outside the family. Assessments should consider:

Whether racial abuse, racial bullying or racial violence impacts on the child or on the

wider family;

The extent of support, advice and intervention offered to the family, or the family

require, and how this can be provided.

Emotional Warmth

2.119 For all children emotional warmth is an essential prerequisite for healthy emotional

development. But how is emotional warmth demonstrated, and to what extent do

cultural variations exist in relation to demonstrating it?

2.120 Much of the literature on emotional abuse and neglect emphasises the absence of

emotional warmth as one indicator of emotional abuse. Hoghhughi and Speight

(1998) emphasise the importance of love, care and commitment to healthy emotional

development:

Children need to feel they are loved consistently and unconditionally.

2.121 In Beyond Blame, Child Abuse Tragedies Revisited, Reder et al (1993) state:

The child must be wanted and treated as a person in his/her own right, whose

feelings are respected and of concern to the parent. In order to provide such care, the

parents must be able to put the child’s needs above their own and tolerate the child’s

dependency and immaturity.

2.122 This represents an important base line for the assessment of emotional warmth.

Parents or carers who are unable or unwilling to respond to the child’s need for

unconditional love and affection will not be able to meet one of the child’s basic

developmental needs.

2.123 All cultures recognise the need for affectionate relationships between adults and

children, just as all cultures create social structures in which these relationships can

develop. There are no differences between cultural groupings in this respect. But

where differences do emerge is in the way in which this emotional warmth is

demonstrated.

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2.124 The demonstration of emotional warmth is also dependent upon rules in a family or

community about physical contact. In some communities, there are more structured

rules about male-female contact than in white English families, but this does not mean

that everyone from that community will behave in exactly the same way in relation to

demonstrating physical affection to children.

2.125 Differences in what constitutes valued social behaviour also creates variations. For

example, in western societies emphasis is placed upon children learning the

distinction between social time with family members and time alone such as at

bedtime. As a result, western bedtime routines encourage children to sleep alone from

quite early ages (Swanick, 1996).

2.126 If separate sleeping is not considered to be such a desired form of child behaviour,

attempts by parents to impose such a pattern onto a child would be considered rigid

and inflexible parenting. On the other hand, for parents who value the independence

of separate sleeping arrangements, shared sleeping may be perceived as inappropriate

and lacking boundaries.

2.127 Over time variations also occur within and between cultures. Fashions in child rearing

practices have a strong influence in the way in which parents are expected to relate to

children. At one time in England within certain white communities it was common

practice to leave babies outside in prams during the day. Today this practice would be

seen as neglectful. The practice of baby massaging, common in many black societies,

was for many years considered to be undesirable and even abusive to children; now

there are classes run by health professionals on baby massage.

2.128 The rise of the child care expert in western societies has exacerbated trends in

parenting. Whereas parents traditionally learnt parenting skills from their own

experience of being parented, today’s parents are required to have a greater level of

knowledge and skills in parenting.

_ Pointers for Practice

There are differences in the way in which affection and love are shown to children by

adults. Some of these will be based on established cultural patterns of behaviour whilst

some will be related more to individual, family or social influences. In assessing

emotional warmth:

Assessments should take account of such variations, whilst still maintaining

consistency in the application of minimum standards of child care;

Professionals need to ensure that base lines are consistent across cultures. It is not

acceptable that parents who demonstrate cold and unloving responses to children

are able to justify their behaviour on the grounds of cultural differences;

In an extended family or clan family structure the whole family may participate in the

parenting of the child, including providing emotional warmth for the child. The

parent–child interaction will only be one of many adult–child, child–child interactions

which should be addressed in an assessment.

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Stimulation

2.129 Just as for emotional warmth, all children require stimulation, and just as for

emotional warmth, the indicators for the presence of appropriate stimulation in an

adult–child relationship have to be understood within a social and cultural context.

2.130 There are a number of myths about stimulation in black families which still have an

impact on professionals today. The two key myths are:

_ That Asian parents do not have toys to stimulate children;

_ That black parents expect children to behave as mini-adults, and take on inappropriate

responsibilities for household tasks.

2.131 The myth that Asian parents do not have toys for children seems to have been based

upon the observations of some child care professionals that certain Asian families did

not have play equipment in their homes.

2.132 For some Asian and Caribbean families in past generations, purchased toys were in

evidence, but were not the main focus of play activity. Particularly for those families

who came from rural parts of India or the Caribbean, game playing took place

outdoors, and play equipment consisted of whatever was available in the fields and

woods where the play took place. The same was true for many white families who grew

up in similar environments in England. In a move to a colder, urban environment, the

opportunity for outdoor play was severely curtailed. Children were unable to create

their own games and exploration became supervised and controlled. Play thus became

a more organised and contained activity. Within this context families also adapted to

their changed environment, and toys have become the main focus for play for all

children whether black or white.

_ Pointers for Practice

_ In assessing stimulation in black families it is important to recognise that children’s

learning may be encouraged in a range of ways, and that the trappings of a

stimulating environment, such as toys and play equipment are not guarantors of a

stimulating environment for children. In assessing families workers should make

sense of different practices.

_ In western societies the concept of childhood is underpinned by the desire to be free

of adult responsibilities and to have opportunities for explanation, learning and play.

In many black families children are not expected to take on adult responsibilities, but

they are expected to learn certain skills that will prepare them for adult life. Whilst

western values encourage pretend play, many black families take pride in teaching

children the basics of cooking and child care at quite young ages.

Guidance, Boundaries and Stability

2.133 Currently, guidance and boundaries is perhaps the most conflictual area of parenting

for many black parents. It is also the area in which many black families seek stability in

a changing world, through the maintenance of traditional values.

60

2.134 There are inherent tensions created by trying to maintain a strong sense of black

culture and heritage, whilst at the same time living in an industrialised western and

racist environment with very different values from the traditions of Africa, the

Caribbean or Asia.

2.135 Black parents recognise and worry about these tensions:

Along with trends in the wider UK population, there appears to be a trend among

black families towards an emphasis on co-operation rather than the discipline of

physical control... This has been assisted by changes to UK statutes, which some

Black parents view as very child-centred, and also as a double-edged sword (Hylton,

1997).

2.136 Black parents wish to imbue their children with the values which they hope will help

their children to survive in a hostile environment, but they are concerned that their

values do not have the support of many professionals.

Black parents often find that what is being reinforced at home varies greatly from at

school, so both child and parent are in a dilemma regarding support for what they

value within their culture (Grant, 1996).

2.137 At the heart of the value conflict between black and white western values lies different

perspectives on independence.

In non-Western European extended families, autonomy and competence are

differently defined. There is more likely to be an emphasis on parents raising

children to be “dependable” – that is to take on a role within the extended family,

rather than be independent. This can cause much friction in the home for children

who have grown up within western society (Grant, 1996).

2.138 Dosanjh and Ghuman’s study (1998) confirms the desire of many Asian parents to

maintain traditional values:

From the responses of the Punjabi mothers of both generations we infer that they

are in favour of encouraging their children to be conscious of, and to appreciate, the

custom of familial interdependence rather than to follow and absorb the Euro-

American style of rugged individualism.

2.139 This is essential if professionals are to gain the support of black families as partners in

the protection of black children. Black families at present perceive child welfare

professionals as undermining of black communities. In Hylton’s study, one black

parent speaks for many:

(UK) society is destroying the black family in the sense that the very same society

that said to you, you cannot scold your children, you cannot speak too roughly to

your children, will take your child away from you and put your child in a social

environment … so that the values that they pass down to your children are worse

than what you would give … and it’s the same society that would pick up your child

that they took away from you in the first place, and put your child behind bars, and

say he’s a criminal.

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_ Pointers for Practice

In assessing guidance and boundaries, professionals should understand the context in

which these are developed. In undertaking assessments:

Professionals should be aware that black families at present perceive child welfare

professionals as undermining of black communities, particularly in relation to the

guidance of and boundaries for young people;

The imposition of a western and individualised model of autonomy and independence

is at variance with the values of many black families, and it’s application in

assessment and intervention can destabilise families and family support networks;

Where intergenerational or family conflicts arise in relation to guidance and

boundaries, negotiations are necessary to reconcile differences.

Domain: Family And Environmental Factors

2.140 Social work with children and families is, as Macdonald (1991) acknowledges ‘rooted

in the pain and suffering of people who are struggling against odds which are

sometimes too great, whether that is due to illness, poverty, racism, homelessness or

other strains and pressures’.

2.141 Any assessment that ignores the wider context of social and economic factors and its

impact on family life, is incomplete as is one which further ignores racism and its

impact on the social and economic context of black families.

2.142 This section draws on research and other evidence to highlight some of the issues

pertinent to black families regarding family and environmental factors. This

information sets out the wider socio-economic context of black families. The general

issues may or may not all be relevant to each family and even where it is relevant will

not affect all families in the same way.

_ Pointers for Practice

Each of the dimensions identified should not be seen in isolation from each other. For

instance, having a large family may not in itself be a problem for any one family but if

the family are also experiencing overcrowding and low income it may result in family

members experiencing additional stress. Any assessment process should take account

of the impact on the family of the various factors interacting with each other.

Family History and Functioning

Family size

2.143 An analysis of the 1991 census shows (Haskey, 1997):

_ of every thousand Black Caribbean families, 540 are families with children;

_ for the Pakistani community this figure is 810 per thousand families;

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_ and 840 out of every thousand families for the Bangladeshi community;

_ The comparative figure for white communities is 417 per thousand families.

2.144 There are some differences in the family sizes of different black communities. A recent

survey (PSI, 1997) shows, for instance, that Pakistani and Bangladeshi people have

larger families with 33% and 42% of them respectively having four or more children.

In comparison, in Caribbean communities the percentage of families with four or

more children is 7%, in Indian families 11% and in Chinese and African-Asian

families 3%.

2.145 As Butt and Mizra (1996) conclude ‘For the vast majority of black communities,

family units with children under the age of 16 are a common experience.

Furthermore, these families are likely to have more children under the age of 16 than

their white counterparts’.

Family structure and arrangements

2.146 Butt and Box (1998) observe that public debate on families ‘often conflates marital

status and the actual living arrangements of families, and on occasion unmarried

mothers and lone parents are seen as interchangeable’. The 1991 census has allowed

both issues to be explored. In relation to marital status, the data shows that whilst over

66% of India, Pakistani and Bangladeshi men over 16 are married, over 47% of

Caribbean men over the age of 16 are single. In relation to different family types, the

census analysis also shows that whilst 55% of Caribbean families with children under

16 are lone parents, 92% of Indian families with children under 16 are married couple

families (Haskey, 1997).

2.147 The ONS (1996) suggests:

_ around 54% of black Caribbean children are brought up in lone mother

households and 3% in lone father households;

_ for children of Indian origin around 7% are in lone mother households and around

1% in lone father households;

_ for Pakistani and Bangladeshi communities the figures are 8% in lone mother and

1% in lone father households;

_ for the Chinese community 11% of children are being brought up on lone mother

and 1% in lone father households.

2.148 Regarding family structures for children in the ‘Black other’ category, the ONS (1996)

figures suggest that 49% of children categorised as ‘Black other’ live in lone mother

households and 2% live in lone father households. Two separate studies (Barn, 1993;

Barn et al, 1997) also show that the majority of looked after children of dual heritage

in these studies had a white mother and the majority of their parents had never

married.

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_ Pointers for Practice

In assessing black families it is important to take account of family size and structure.

For instance, a family with three or more children with a low income and poor

housing is a family likely to experience hardship. Any assessment process should

address the implications of this for families;

Although the fact of a lone parent household in itself may not be an issue for an

individual family, a lone parent household with no support networks may impact on

family functioning. Furthermore, lone parenthood can have an impact on income

and wealth, and in turn can impact on the material wellbeing of children. This should

be taken account of in an assessment.

In relation to a child of dual heritage assessments should consider the implications of

family arrangements on the child and family. For instance how does living in a white

only household impact on the child’s position within the family, or how does a single

white mother’s isolation from her community affect her relationship with her child?

It is important for assessors to understand that the evidence of a higher incidence of

lone parenthood amongst Caribbean people does not rule out exploration of the

issue of ‘visiting’ relationships, where the responsibility for care of the children may

be shared although the parents may not live together.

Parenting strengths and difficulties

2.149 Despite the social and economic impact of racism on families and the detrimental

impact of immigration laws and racial violence on families and communities, over

many generations black families have demonstrated strengths and resilience in the face

of adversity. Unfortunately social work practice with black families has often failed to

work with the strengths of black families and has relied instead on a problem oriented

approach to black families.

2.150 A deficit model which views families as dysfunctional can preclude adequate support

being provided to families. For instance, evidence shows that where professionals fail

to provide adequate support in the early stages of intervention there is an increased

likelihood of the child becoming looked after (Barn, 1993).

2.151 It is also apparent that race is a factor in the support offered to black families. Many black

families do not access family support services (Butt and Box, 1998) and the Tyra Henry

and Sukina Hammond Inquiry Reports demonstrate that racism and gender based

stereotyping can impact on the amount and timing of the support which is offered.

_ Pointers for Practice

Assessments should inform interventions which build on the strengths of black

families, whilst ensuring that areas of difficulty or potential risk to the child’s safety

are identified and addressed appropriately;

An empowerment model of assessment should recognise the life experiences of

black families, particularly the ability of families to survive and resist a system that is

disadvantaging;

64

Targeted support to address family problems should be based on an understanding

of a family’s circumstances as the result of the assessment process rather than on the

basis of assumptions underpinned by stereotypical beliefs of black families.

Wider Family

2.152 The wider family, often referred to as the extended family, has been an important

feature of the lives of many black and minority ethnic people. Hylton (1997) notes, in

his study of the survival strategies used by black families, that the majority of black

people ‘rarely made a disconnection between the unit of mother, father and child – the

so called nuclear family – and relatives such as grandparents, sisters, brothers, aunts

and uncles. They were all collectively known as the “family”’.

2.153 For many, the wider family is not restricted to aunts, uncles and grandparents, but as has

already been highlighted earlier, includes family friends and other non-blood relatives.

2.154 However, not all individual black families will have this wide family network. This is

of particular relevance for many refugee and asylum seeking individuals and families

who have left their homeland alone or with their immediate family. For these people,

in common with other black people, the family in the wider sense is central. Family in

this context could be other refugees and asylum seekers, and links will therefore be

made with individuals and families coming from the same geographical regions.

2.155 For some families with no close family members in this country, links with family and

friends living either in their country of origin or other parts of the world, will be

important.

_ Pointers for Practice

In assessing black families, practitioners should ascertain from children and family

members their perception of who constitutes their wider family and tap into the

strengths that may be present in that wider family network.

Housing

2.156 Butt and Mirza (1996) in reviewing the research data on housing and tenure for black

communities conclude ‘Though a large proportion of black people own their own

accommodation there is evidence to suggest that the black community occupy older

inner city accommodation which lacks basic amenities. Furthermore, black households

are more likely to experience overcrowding compared to the white population’.

2.157 There is some evidence to suggest black people live in neighbourhoods that are

rundown. A survey (PSI, 1997) found:

Ethnic minorities tended to live in areas with higher than average levels of

unemployment, they were more likely than whites to mention environmental

problems such as graffiti, vandalism and vermin infestation, and they were more

likely than whites to report problems of personal and property crime and nuisance

trouble from some young people.

65

Overall, whites were the most likely to say they were very satisfied with the current

neighbourhoods and housing: Caribbean, Bangladeshi’s and the Chinese were the

most likely to be dissatisfied with their local neighbourhoods, and Caribbeans and

Bangladeshi’s were the most dissatisfied with their neighbourhoods.

Employment

2.158 The same PSI Survey (1997) found also that unemployment rates amongst men under

retirement age was the highest amongst Caribbean (31%) Bangladeshi (42%) and

Pakistani men (38%). The unemployment rates amongst Chinese, African Asians and

Indians was 9, 14 and 19 % respectively. In relation to the white community the

percentage is 15.

2.159 For women the Chinese had the lowest rates of unemployment at 6% followed by

whites at 9%, African Asians and Indians 12% and Caribbeans at 18 %. For Pakistani

and Bangladeshi women it was 39% and 40% respectively.

Income

Poverty is more than simply economic deprivation, it means being completely

isolated from the means to change one’s circumstances (Carter, 1998).

2.160 The extent of poverty in black communities is now well documented. Berthoud, in

analysing data from the fourth national survey of ethnic minorities in Britain which

was conducted by PSI/SCPR in 1994, notes that 82% of Pakistani, 84% of

Bangladeshi, 45% of Indians, 41% of Caribbean and 39% of ‘African Asian’

households had incomes that were below half the average income, in comparison to

28% of white households.

2.161 The PSI survey (1997) notes that although there were wide variations in the extent of

poverty in the various black communities, ‘all minorities included in this survey, with

the exception of people of Chinese origin, were disadvantaged with respect to the

white majority’.

2.162 The survey found also that:

_ the extent of poverty among both Pakistani and Bangladeshi households was

outstanding;

_ Caribbean, Indian and African Asian households were more likely to be in poverty,

and less likely to have relatively high family incomes than white households;

_ where financial problems such as arrears and money worries were concerned,

Caribbeans had exceptionally high levels of rent arrears and were much more likely

to report money worries than any other group.

2.163 No specific information exists about the level and extent of poverty and its impact on

black disabled children and their families. Evidence suggests, however, that families

with a disabled child are generally affected significantly by poverty. A national survey

66

(Beresford, 1995) exploring the needs and circumstances of families caring for a

severely disabled child found that families in the survey ‘had substantially lower

incomes than the general population...’. The survey also shows that employment

levels for mothers of disabled children were much lower than for mothers with nondisabled

children and that ‘nine out of ten lone parent families, and a third of two

parent families, had no income other than benefits’.

2.164 Although there are no data available on black children who are disabled the incidence

and prevalence of disability amongst black communities is likely to be either the same

rate and certainly no less than in the white population (Butt and Mirza, 1996). Given

that family units with children are the rule rather than the exception and the disproportionate

levels of poverty in the black communities, it could be safely concluded

that black disabled children are as likely to experience poverty as white disabled

children.

_ Pointers for Practice

In assessing the needs of children and their families it is important to understand the

implications of social and economic context within which families live and more

importantly how fears and worries about money, health, education and employment

impact on family life;

In assessing black families any attempts to disregard the impact of racism on the

social and economic context in which black families live will result in an assessment

which is incomplete.

Families Social Integration

2.165 The extent to which individual black families feel integrated and part of their local

neighbourhood will vary. The following factors might have an impact on the social

integration of black family’s into their neighbourhoods:

_ Black families tend to live in areas of higher than average black population. This is

as much to do with individuals and families choosing to be in surroundings and

with people who appear familiar, as it is to do with people feeling ‘safe in numbers’.

For many black people living amongst a majority of black people gives them a sense

of belonging and provides them with a certain level of support and security;

_ Black communities are not homogeneous. Some black families, although living in

predominantly black areas, may be in cultural or religious minorities in those

communities. This will not, in itself, be problematic but individual families from

those minority groups may find their support network is located outside their

locality. For instance, refugee families may consider support from other refugee

families more appropriate. Their social integration into their locality may be less

important than their social and emotional links with other refugees;

67

_ Many black families live in hostile communities where racial abuse and harassment

are a daily feature of their lives. There are some areas where black families are

frightened to allow their children to play outside home and where adults feel under

siege.

_ Pointers for Practice

Any assessment with individual black families should recognise that although many

black families gain strength from living amongst their own community, there are

individual black families whose experience of living amongst black people may not

necessarily be a positive one. As with the white community, the reasons for any black

family feeling either isolated or ostracised from the majority community will vary.

Whatever the reason it is important to think of the support networks for such

families;

Alongside the individual impact which racial abuse and bullying has on children, it is

important to consider the impact of racial violence on communities. Fear of abuse or

attacks can affect whole ways of life in particular communities which are targeted for

such treatment by reducing the freedom of movement of women, children and older

people in both the hours of daylight and at night. In such cases local authorities

should plan for community safety in a more pro-active and co-ordinated way, using

the auspices of children’s planning processes and area child protection committees,

alongside initiatives to reduce crime and improve safety in the locality.

Community Resources

2.166 The anomalous situation regarding community resources for black communities is

that on one hand black individuals have access to some very positive support from

black voluntary organisations and on the other have little access to resources provided

by the statutory sector and some white voluntary sector organisations.

2.167 In relation to preventative services for children and families provided by statutory

organisations, evidence suggests that black families have less access to those services

than white families. For instance in relation to child protection a study by Farmer and

Owen (1995) found that ‘many black families did not have access to much needed

services. Even after registration this situation often continues, partly because of lack of

appropriate resources’.

2.168 Equally, a study of family centres and their use by black families also found that ‘family

centres are not intrinsically providers of accessible and appropriate services to black

families’ (Butt and Box, 1998).

2.169 Although services from mainstream organisations have been inaccessible black

communities have had some very positive support from black voluntary organisations.

The role of the black voluntary sector in providing much of needed services to

black people is well recognised (Phaure, 1991; Atkin, 1996; Butt and Box, 1998).

Apart from providing much needed services, involvement in black organisations has

also been one of the survival strategies used by many in the black communities

(Hylton, 1997).

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69

_ Pointers for Practice

During the assessment process professionals should ascertain from families what are

their perceptions of available community resources what kinds of services would be

most helpful to them and how to make statutory sector services appropriate and

accessible to them.

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economy of care. Race and Community Care. Open University Press.

Banks N (1992) Some considerations of racial identification when working with

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London.

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the circumstances leading to her death. The Bridge, London.

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families. REU, London.

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Introduction

3.1 The Assessment Framework is designed to be inclusive of all children in need. Social

Services Departments have a duty to ensure that every child is assessed in a way which

recognises the child’s individuality and particular needs. For many reasons, disabled

children are more likely to come to the attention of health, education and social

services and are far more likely to be assessed than other children. This guidance is

therefore aimed at everyone involved in assessments, not just at those who have a

specialist role with disabled children.

3.2 An assessment is a positive opportunity to identify and respond to the needs of

children and families. It is most likely to be helpful to a child and family if it draws

together multi-disciplinary expertise. Serious concerns have been raised about the

quality of assessments of disabled children (Audit Commission, 1994; Department of

Health, 1994; 1998a; 1998b; Morris, 1998b; Kagan et al,1998; Middleton,1999).

The process of assessment and the likelihood of multiple assessment arrangements

may compound the difficulties facing disabled children and their families and result in

conflicting messages about the needs and the most effective types of intervention/or

support. As stated in the Guidance (Department of Health et al, 2000, paragraph

1.42):

… since discrimination of all kinds is an everyday reality in many children’s lives,

every effort must be made to ensure that agencies responses do not reflect or

reinforce that experience and indeed, should counteract it.

3.3 In the past, disabled children have often been excluded from or marginalised within

mainstream services, and many standard assessment frameworks and approaches have

been developed with only non-disabled children in mind. The Children Act 1989

emphasises disabled children are ‘children first’ and the Assessment Framework is

based on this principle of inclusion. However, recognising disabled children as

children first does not imply denial of a child’s particular needs: ‘Ensuring equality of

opportunity does not mean that all children are treated the same. It does mean

understanding and working sensitively and knowledgeably with diversity…’

(Department of Health et al, 2000, paragraph 1.43).

3.4 This practice guidance aims to assist those undertaking assessments of need, by

enabling practitioners and managers to understand and work more sensitively with

disabled children and their families. It is intended that the use of the Assessment

Framework will mark a radical departure in assessment, moving from single agency

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3 Assessing the needs of disabled children

and their families

service led assessments to assessments of the whole child by a co-ordinated group of

professionals.

3.5 In preparation for this chapter Triangle consulted with disabled children through

aMaze, a Brighton based project providing advice, information and support to assist

parents to obtain the best for their disabled children. Quotes referenced as personal

communication are from these groups and we are grateful for the children’s consent to

use their words.

Disabled children and the Assessment Framework

3.6 The basic needs of disabled children are no different to those of any other child. The

domains and dimensions of the Assessment Framework are relevant for all children.

‘Professionals working with children need not and should not start from a different

position when the children are disabled’ (Middleton, 1999 p.92). While disabled

children’s basic needs are the same as all children’s needs, impairments may create

additional needs. Disabled children are also likely to face additional disabling barriers

which inhibit or prevent their inclusion in society. The assessment of a disabled child

must address the needs of the parent carers. Recognising the needs of parent carers is a

core component in agreeing services which will promote the welfare of the disabled

child. The main part of this chapter considers the needs and barriers in relation to each

of the dimensions of the Assessment Framework.

3.7 The Assessment Framework is highly relevant for disabled children, for example the

emphasis on responding to a child’s individual needs; the expectation of children’s

involvement in the process; the commitment to working with parents and children;

the emphasis on inter-agency working and the underlying ecological and

empowerment models. A careful assessment that involves the child should be a helpful

experience and result in real improvements in a child’s life. Information from

assessments can result in changes in the nature of service provision, especially if unmet

need is recorded and used to inform children’s services planning processes. Good

quality assessments will also encourage active partnerships between mainstream and

specialist services; working together to maximise disabled children’s inclusion in

family life, education and community services.

3.8 Depending on the definitions and methodology used, between 3% and 5% of

children in the United Kingdom are classified as disabled (OPCS, 1986; Department

of Health, 1998a). Different definitions of disability and a summary of the legislation

are in Appendix 4.

3.9 Childhood disability arouses very strong feelings and touches on some of our most

fundamental beliefs and assumptions. The cultural context in which assessments of

disabled children take place is not a neutral one: disabled children and adults face major

barriers to participating as equal members of our society. There are different ways of

defining and understanding disability. Within the disabled people’s movement, and

within some services and some professional groups, there has been a move from an

individual to a social model of disability. ‘The individual model locates the ‘problem’ of

disability within the individual and sees the causes as functional limitations or psychological

losses assumed to arise from disability’(Oliver, 1999, p.33).

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3.10 This guidance is informed by an understanding of the ‘social model’ of disability,

which uses the term disability not to refer to impairment (functional limitations) but

rather to describe the effects of prejudice and discrimination: the social factors which

create barriers, deny opportunities, and thereby dis-able people (Morris, 1998c;

Oliver, 1999). Children’s impairments can of course create genuine difficulties in their

lives. However, many of the problems faced by disabled children are not caused by

their conditions or impairments, but by societal values, service structures, or adult

behaviour (Shakespeare and Watson, 1998):

a major problem for disabled children is that they live in a society which views

childhood impairment as deeply problematic (p.20).

3.11 Effective assessment of a disabled child must consider:

_ the direct impact of a child’s impairment;

_ any disabling barriers that the child faces; and

_ how to overcome such barriers.

Disabled Children and assessment

3.12 Disabled children are far more likely than non-disabled children to be subject to

multiple assessments by health, education and social services. There are several reasons

for this:

_ There are more disabled children in groups already socially disadvantaged.

Whatever system is used to classify disability, there are twice the number of disabled

children in social class 5 households as in social class 1 and there is a strong

relationship between childhood disability and poverty/household income

(Department of Health, 1998a; Dobson and Middleton,1999). The increased

prevalence of certain impairments in some minority ethnic groups has also been

linked to social disadvantage (Murphy et al, 1998).

_ Disabled children are more likely to have a number of experiences that may

trigger assessment. Disabled children face an increased risk of abuse (Westcott,

1993; Westcott and Cross, 1996; Westcott and Jones, 1999); and of school

exclusion and social exclusion in its widest sense (Middleton, 1999). Disabled

children are more likely to live away from home: to be accommodated on a short or

long-term basis and/or to be in state-funded residential education.

_ Assessment has become the route to ordinary entitlements for many disabled

children and their families.Disabled children often have to be assessed to access the

same basic provisions as non-disabled children, for example education, housing,

play and leisure opportunities.

_ Assessment of special educational needs. Many disabled children are assessed

before they reach statutory school age because it is likely they will have special

educational needs (SEN).

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Using assessments positively with disabled children

and young people

3.13 When planning an assessment involving a disabled child it is important to:

_ think about your own understanding of disability;

_ take into account the child’s experience and understanding of assessment;

_ take into account the family’s experience and understanding of assessment;

_ be clear about the focus of an assessment;

_ find out who else is currently involved with the child;

_ gather information from existing assessments;

_ access helpful information on specific childhood impairments.

Each of these areas will be addressed in turn.

3.14 Think about your own understanding of disability.Our perceptions of what it means

to be disabled will affect our work. It is essential to actively explore our own attitudes

and understanding, and to be aware of our own prejudices, fears and stereotypes about

disability and about particular impairments. The inclusive approach of the

Assessment Framework should be reflected in all areas of practice. Are disabled

children made to feel welcome by your services? Is your building fully accessible? Do

you employ disabled workers? Are your toys, books and resources suitable for all

children? Are there positive images of disabled children around? Do you have a clear

policy on anti-discriminatory practice? Are staff offered information, training and

support on the inclusion of disabled children within the service? Is disability equality

training offered to staff? Can facilities and approaches be adapted for the communication

needs of disabled children, for example loop systems and/or use of signing for

deaf children?

3.15 Take into account the child’s experience and understanding of assessment.Disabled

children are likely to have been assessed, often frequently, and often within a pathologising,

deficit model where the child was tested against some concept of normality. For

some disabled children, the very word assessment may have unhelpful connotations:

Its always about what’s wrong with me ... they’re only interested in the bits of me that

don’t work. They want to see what I can’t do (11 year old disabled girl, personal

communication).

Disabled children and young people may not be used to active involvement in

assessment processes. Children are entitled to an explanation of the assessment which

is appropriate to their age and understanding. As far as is possible, the purpose should

be agreed with the child as an assessment of their situation rather than of the child him

or herself. This enables the child to become an essential part of the assessment team,

contributing to information gathering and decision making, rather than being the

passive focus of the exercise.

3.16 Take into account the family’s experience and understanding of assessment.

Families of disabled children will also have experienced many assessments. Some

families describe dealing with service providers as the most difficult aspect of caring for

76

their disabled children (Department of Health, 1998b, p.32). In one study, only 25%

of parents of disabled children felt that assessment arrangements were well coordinated

(Audit Commission, 1994). Assessments can undoubtedly be traumatic

and difficult for some families:

I found assessment meetings a nightmare. I felt I was listening to people talk about

somebody other than the child I lived with. After the first assessment at the child

development centre I went home and cried for four days... (Parent of disabled child,

quoted in Murray and Penman, 1996).

3.17 Families require clear information about the focus of any assessment and about

available services providing support. Parents should be clearly informed that their

views and priorities are important and they should be encouraged to contribute to the

process. The process should include recognition of the parent carers needs in bringing

up their children.

3.18 Some families would like friends, advocates or relatives to support them during

assessments and this should be facilitated. Experience with named persons in

education indicates that discussions can be more positive and open when families who

wish for support are accompanied by their own adviser or friend (Russell, 1999).

3.19 Parents of disabled children can be assigned multiple and sometimes contradictory

roles by professionals. Twigg and Atkin (1993) describe the range of ways that professionals

in social and health care systems conceptualise and respond to parents: they are

perceived, simultaneously, as resources for the statutory services, co-workers and

service recipients in their own right, while their children may or may not be also

perceived as service recipients. This can create an ambiguous and confused

relationship.

3.20 Be clear about the focus of an assessment. The Assessment Guidance states:

However difficult the circumstances, the purpose of assessing the particular child

and the family should always be kept in mind (paragraph 3.37).

3.21 Assessments should focus on the circumstances of the child and family and not just on

an individual and whether a particular service is available. For disabled children in

particular, there is a concern that assessments may be focused around assessing the

child’s problems, or assessing the child for specific services, rather than assessing the

child’s overall situation and needs. The most recent Department of Health inspection

of services to disabled children found that ‘There were very few needs-led assessments

... more frequently families were subject to a number of parallel assessments, often

trawling through the same information but with a different service in mind’

(Department of Health, 1998b, p.23).

3.22 Clarity of focus will also enable parents and children to contribute more effectively to

an assessment. As an example, parents may perceive a broad assessment of a child’s

social integration that considers the possibility of using inclusive play and leisure

facilities as an attempt to remove existing respite care arrangements. Clarity about the

focus of the assessment is likely to diminish such anxieties.

3.23 In many cases practical help is most effective for a family with a disabled child, for

example advice about benefits or the timely provision of aids and adaptations in the

home. The needs of disabled children and their families for specialist disability

77

equipment and assistive technology should be included in the assessment process.

Equipment could range from a wheelchair and communication aid for the disabled

child to special beds and lifting equipment to help parents or other carers. Assessment

for equipment may need to involve several professionals on a multi-disciplinary basis

and collaboration across agencies, particularly where different types of equipment

have to be integrated. Where the relevant expertise is not available at local level,

specialist centres such as communications aids centres may need to become involved.

The views and wishes of the child and parents should be taken into account. A choice

of equipment and the opportunity to try it out, for example by visiting a disabled

living centre, should be offered as far as possible.

3.24 Find out who else is involved currently with the child. Assessment processes ‘should

be co-ordinated at all stages’ (Department of Health, 1998b, p.57) and assessments of

disabled children may be undertaken jointly with shared responsibility across agency

boundaries (Department of Health et al, 2000).

3.25 Services for disabled children are often fragmented between different agencies.

Different perspectives, values and professional languages can complicate working

together across agency and discipline boundaries. Young disabled children often come

sequentially to the attention of health, then education and then social services.