Assessing Children in Need and their Families:
Department of Health
in Need and their
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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
Appendix 2 Genogram 29
Appendix 3 Ecomap 30
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
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
2.160 Income 66
2.165 Families Social Integration 67
2.166 Community Resources 68
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
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
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
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.
MINISTER OF STATE FOR SOCIAL SERVICES
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
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.
SOCIAL CARE GROUP
DEPARTMENT OF HEALTH
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.
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
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).
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 Knowledge underpinning the Assessment
Family & Social
CHILD’S DEVELOPMENTAL NEEDS
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 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.
Age Period Task
Infancy to preschool Attachment to caregiver(s)
Differentiation of self from environment
Self control & compliance
Middle childhood School adjustment (attendance, appropriate conduct)
Academic achievement (eg. learning to read, do
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,
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
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
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
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
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
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).
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
Table 11 Risks/stressors and protectors/resources relevant to children
Risk/stressor Factor Protector
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
Discordant/distant Parent-child relationship Warm/mutual
Lax/hostile/no control Parenting Positive, eg. co-operation
Neglect, abuse and good control,
Distant/discordant/violent Inter-parental relationship Mutually
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
Loss and other negative life events and Life events and experiences Positive life events,
experiences acknowledgement of
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).
Coping with puberty without support. Factual information about puberty, sex
Denying own needs and feelings. A mutual friend.
Unstigmatised support of relevant
An increased risk of psychological The ability to separate themselves either
problems, behavioural disorders, psychologically or physically from
suicidal behaviours and offending. stressful situations.
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
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
_ Express themselves simply and clearly and use concepts which are familiar to
_ Match their explanations of new ideas to the children’s age and levels of
_ 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.
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:
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:
(parental personality, child characteristics)
(parental developmental history)
(partner satisfaction, social support network)
(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.
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
maltreatment, including physical, sexual and emotional abuse, both where children
are living with their families and elsewhere (Department of Health, 2000a).
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
_ 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
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
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
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
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
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
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
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
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
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
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
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.
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)
Figure 3 A developmental and ecological perspective on child maltreatment
Reabuse, child safety
Social and family support
Cultural and social influences
Social contacts Work
PRE-EXISTING INFLUENCES SETTING FOR ABUSE
(Ecology of maltreatment)
(Compensatory or potentiating)
(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.
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
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
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
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.
Posture and large
Vision and fine
Hearing and speech
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
At rest, hands closed and thumb turned in.
Fingers and toes fan out during extenor movements
When cheek touched, turns to same side; ear gently
rubbed, turns head away.
When lifted or pulled to sit head falls loosely
Held sitting, head falls forward, with back in one
Placed downwards on face, head immediately turns
to side; arms and legs flexed under body, buttocks
Held standing on hard surface, presses down feet,
straightens body and often makes reflex ‘stepping’
Turns head and eyes towards light.
Stares expressionlessly at brightness of window or
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
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.)
Sleeps much of the time when not being fed or
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
Now prefers to lie on back with head in mid-line.
Limbs more pliable, movements smoother and more
Waves arms symmetrically. Hands now loosely
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
Held standing with feet on hard surface, sags at
Visually very alert, particularly interested in nearby
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
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
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
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
May turn eyes and head towards sound; brows may
wrinkle and eyes dilate.
Often licks lips in response to sounds of preparation
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
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
Chart illustrating the developmental progress of infants and young children
Posture and large
Vision and fine
Hearing and speech
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
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
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
(Watches rolling balls of 2 to 1/4 inch diameter at
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
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.
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.
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
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
Shouts to attract attention, listens, then shouts
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
Clearly distinguishes strangers from familiars, and
requires reassurance before accepting their
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.
Holds out toy held in hand to adult, but cannot yet
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
Posture and large
Vision and fine
Hearing and speech
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
Throws toys deliberately and watches them fall to
Looks in correct place for toys which roll out of
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
Recognises familiars approaching from 20 feet or
Uses both hands freely, but may show preference
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
May hand examine common objects on request, eg.
spoon, cup, ball, shoe.
(Immediate response to baby tests at 3–41/2 feet but
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,
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
Demonstrates affection to familiars.
Waves ‘bye-bye’ and claps hands in imitation or
Child sits, or sometimes stands without support,
while mother dresses.
Walks unevenly with feet wide apart, arms slightly
flexed and held above head or at shoulder level to
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.
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
Looks with interest at pictures in book and pats
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
Jabbers loudly and freely, using wide range of
inflections and phonetic units.
Speaks 2–6 recognisable words and understands
Vocalises wishes and needs at table.
Points to familiar persons, animals, toys, etc., when
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
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.
Closely dependent upon adult’s reassuring
Needs constant supervision to protect child from
dangers of extended exploration and exploitation of
Chart illustrating the developmental progress of infants and young children – continued
Posture and large
Vision and fine
Hearing and speech
Walks well with feet only slightly apart, starts and
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
Walks upstairs with helping hand.
Creeps backwards down stairs.
Occasionally bumps down a few steps on buttocks
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
(Possibly recognises special miniature toys at 10
Continues to jabber tunefully to himself at play.
Uses 6–20 recognisable words and understands
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
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
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,
Alternates between clinging and resistance.
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
Turns pages singly.
Recognises familiar adults in photograph after once
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
Uses 50 or more recognisable words and
understands many more.
Puts 2 or more words together to form simple
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
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
Posture and large
Vision and fine
Hearing and speech
Walks upstairs alone but downstairs holding rail,
two feet to a step.
Runs well straight forward and climbs easy nursery
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
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
Paints strokes, dots and circular shapes on easel.
Recognises himself in photographs when once
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.
Continually asking questions beginning ‘What?’,
Uses pronouns, I, me and you.
Stuttering in eagerness common.
Says a few nursery rhymes.
Enjoys simple familiar stories read from picture
(6 toy test, 4 animal picture test, 1st cube test. Full
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
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
Watches other children at play interestedly and
occasionally joins in for a few minutes, but little
notion of sharing playthings or adult’s attention.
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
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
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
Carries on simple conversations, and verbalises past
Asks many questions beginning ‘What?’, ‘Where?’,
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
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
Posture and large
Vision and fine
Hearing and speech
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
Builds tower of 10 or more cubes and several
‘bridges’ of three on request.
Builds three steps with six cubes after
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
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
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
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
Understands taking turns.
Shows concern for younger siblings and sympathy
for playmates in distress.
Appreciates past, present and future.
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
Grips strongly with either hand.
Picks up minute objects when each eye is covered
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
Counts fingers on one hand with index finger of
Names four primary colours and matches 10 or 12
(Full nine-letter vision chart at 20 feet and near test
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
Domestic and dramatic play continued from day to
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
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.
APPENDIX 2 Genogram
First child Second child Miscarriage or
Male Female Gender unknown
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.
APPENDIX 3 Ecomap
_ 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
Acheson D (1998) Independent Inquiry into Inequalities in Health. The Stationery
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.
British Agencies for Adoption and Fostering (1999) Making Good Assessments.
Preparing for Permanence – A Practical Resource Guide. BAAF, London.
Bandura A (1997) Social Learning Theory. Prentice-Hall, Englewood, NJ.
Bebbington A and Miles J (1989) The Background of Children who enter Local
Authority Care. British Journal of Social Work 19: 5, pp.349–368.
Belsky Y J and Vondra J (1989) Lessons from child abuse: The determinants of parenting.
In Cicchetti D and Carlson V (eds) (1989) Child Maltreatment: Theory and Research
on the Causes and Consequences of Child Abuse and Neglect. Cambridge University
Press, New York.
Bentovim A (1998) Significant Harm in Context. In Adcock M and White R (eds)
(1998) Significant Harm: its Management and Outcome. pp.57–89. Significant
Bowlby J (1969) Attachment and Loss, Vol I Attachment. Hogarth Press, London
Bowlby J (1973) Attachment and Loss, Vol II Separation: Anxiety and Anger. Basic
Books, New York.
Bowlby J (1980) Attachment and Loss, Vol III Loss: Sadness and Depressions. Basic
Books, New York.
Bradshaw J (1990) Child Poverty and Deprivation in the UK. NCB, London.
Brandon M, Lewis A, Thoburn J and Way A (1999) Safeguarding Children with the
Children Act 1989. The Stationery Office, London.
Brearley J (1991) Counselling and Social Work. Open University Press, Buckingham.
Bronfonbrenner U (1979) The Ecology of Human Development: Experiments by Nature
and Design. Harvard University Press, Cambridge.
References – Chapter 1
Buchanan A (1999) What works for Troubled Children. Family support for children with
emotional and behavioural problems. Barnardo’s, London.
Buchanan A (ed) (1994) Partnership in Practice. Avebury, Aldershot.
Buchanan A and Hudson B L (1998) Parenting, Schooling and Children’s Behaviour –
interdisciplinary approaches. Ashgate, Hampshire.
Butler I and Williamson H (1994) Children Speak: children, trauma and social work.
Longman, Essex. In NSPCC in association with Chailey Heritage and Department of
Health (1997) Turning Points: A Resource Pack for Communicating with Children.
Introduction. pp.1–2. The NSPCC, London.
Butt J and Box C (1998) Family Centred. A study of the use of family centres by black
families. REU, London.
Capaldi D and Eddy M (in press) Improving Children’s Long Term Well-being by
Preventing Anti-Social Behaviour. In Buchannan A and Hudson B L (in press)
Promoting the Emotional Well-being of Children. Messages from Research. Oxford
University Press, Oxford.
Carlson V, Cicchetti D, Barnett D and Braunwald K (1989) Disorganised/
Disoriented attachment relationships in maltreatment infants. Developmental
Psychology. 25: 525–531.
Cleaver H (1991) Vunerable Children in Schools. Dartmouth, Aldershot.
Cleaver H (1996) Child Abuse which involved wider kin and family friends. In Bibby P
(ed) Organised Abuse: The Current Debate. Ashgate, Aldershot.
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
Cleaver H (2000b) Fostering Family Contact: a study of children, parents and foster
carers. The Stationery Office, London.
Cleaver H and Freeman P (1995) Parental Perspectives in Cases of Suspected Child
Abuse. HMSO, London.
Cleaver H, Unell I and Aldgate J (1999) Children’s Needs – Parenting Capacity: The
impact of parental mental illness, problem alcohol and drug use, and domestic violence on
children’s development. The Stationery Office, London.
Coohey C (1996) Child Maltreatment: Testing the social isolation hypothesis. Child
Abuse and Neglect. 20: 241–254.
Cox A (1993) Preventive aspects of child psychiatry. Archives of Disease in Childhood.
Crittenden P M and Ainsworth M D S (1989) Child Maltreatment and Attachment. In
Cicchetti D and Carlson V (eds) Handbook of Child Maltreatment: Clinical and
Theorectical Perspectives. pp.432–463. Cambridge, New York.
Department of Health (1989) The Care of Children: Principles and Practice in
Regulations and Guidance. HMSO, London.
Department of Health (1991a) Child Abuse. A Study of Inquiry Reports 1980–1989.
Department of Health (1991b) Patterns and Outcomes in Child Placement. Messages
from current research and their implications. HMSO, London.
Department of Health (1995) Child Protection: Messages from Research. HMSO,
Department of Health (1996) Focus on Teenagers: Research into Practice. HMSO,
Department of Health (1999) Adoption Now: Messages from Inspection. Wiley,
Department of Health (2000a) towards safer care. Training and Resource Pack. The
Department of Health, London.
Department of Health (2000b) Studies which inform the development of the Framework
for the Assessment of Children in Need and their Families. The Stationery Office,
Department of Health (forthcoming) The Children Act 1989 Now: Messages from
Research. The Stationery Office, London.
Department of Health, the Department of Education and Employment and the
Home Office (2000) Framework for the Assessment of Children in Need and their
Families. The Stationery Office, London.
Department of Health and Social Security (1982) Child Abuse: A Study of Inquiry
Reports. HMSO, London.
Department of Health and the Welsh Office (1997) People Like Us. Report of the
Review of the Safeguards for Children Living Away from Home. The Stationery Office,
Fahlberg V I (1981) Attachment and Separation. BAAF, London.
Fahlberg V I (1991) A Child’s Journey through Placement. BAAF, London
Falkov A (1996) A Study of Working Together “Part 8” Reports: Fatal child abuse and
parental psychiatric disorder. Department of Health – ACPC Series I. Department of
Falkov A (ed) (1998) Crossing Bridges – Training resources for working with mentally ill
parents and their children. Reader – for managers, practitioners and trainers. Pavilion
Farmer E and Owen M (1995) Child Protection Practice: Private Risks and Public
Remedies. HMSO, London.
Garbarino J (1982) Children and Families in the Social Environment. Aldine, New
Ghate D and Hazel N (forthcoming) Parenting in poor environments: A national study
of parents and stress.
Gilligan R (2000) Promoting Positive Outcomes for Children in Need: The Assessment of
Protective Factors. In Horwath J (ed) (2000) The Child’s World: Assessing Children in
Need. The Reader. The NSPCC, London.
Gorrell-Barnes G (1994) Family Therapy. In Rutter M, Taylor E and Hersov L (eds)
Child and Adolescent Psychiatry: Modern Approaches. pp.946–967. Blackwell, London.
Haggerty R J, Sherrod L R, Garmezy N and Rutter M (1996) Stress, Risk and Resilience
in Children and Adolescents. Cambridge University Press, Cambridge.
Hallett C (1995) Inter-agency Co-ordination in Child Protection. HMSO, London.
Hallett C and Stevenson O (1980) Child Abuse: aspects of inter-professional cooperation.
Allen and Unwin, London.
Higham P (1999) Reach Out – But will we be there? In Community Care 29 April – 5
May 1999. pp.24–25.
Hill M, Laybourn A and Brown J (1996) Children whose parents misuse alcohol: a
study of services and needs. Child and Family Social Work. 1: 159–167.
Holman B (1998) Faith in the Poor. Lion Publishing, Oxford.
Home Office (1950) Children neglected or ill-treated in their own homes. Joint Circular
with Ministry of Health and Ministry of Education.
Horwath J (ed) (2000) The Child’s World: Assessing Children in Need. The Reader. The
Hudson B L (1991) Behavioural Social Work. In Lishman J (ed) Handbook of Theory for
Practice Teachers in Social Work. Jessica Kingsley, London.
Hudson B, Hardy B, Henwood M and Wistow G (1999) In Pursuit of Inter-Agency
Collaboration: What is the contribution of theory and research? Public Management:
an international journal of research and theory. 1(2): 235–260.
Hudson B (2000) Inter-agency collaboration – a sceptical view. In Brechin A, Brown H
and Eby M A (eds) (2000) Critical Practice in Health and Social Care. The Open
Hunt J, McLeod A and Thomas C (1999) The Last Resort. The Stationery Office,
Iwaniec D (1996) The Emotionally Abused and Neglected Child.Wiley, Chichester.
Jack G (1997) An Ecological Approach to Social Work with Children and Families.
Child and Family Social Work. 2: 109–120.
Jackson S (1987) The Education of Children in Care. University of Bristol, School of
Applied Social Studies, Bristol.
Jewitt C (1984) Helping Children Cope with Separation and Loss. Batsford/BAAF,
Jones D P H (1998) The effectiveness of of intervention. In Adcock M and White R (eds)
(1998) Significant Harm: its Management and Outcome. pp.91–119. Significant
Jones D and Ramchandani P (1999) Child Sexual Abuse: Informing Practice from
Research. Radcliffe Medical Press. Abingdon.
Jones DPH, Newbold C and Byrne G (1999) Management, Treatment and Outcomes.
In Eminson M and Posslethwaite R (eds) (1999) Munchausen Syndrome by Proxy
Katz A, Buchanan A and Ten Brinke J-A (1997) The Can Do Girls – A Barometer of
Change.Department of Applied Social Studies and Research, Oxford.
Lawton D (1998) The Number and Characteristics of Families with More than One
Disabled Child. Social Policy Research Unit, University of York.
Masten A and Coatsworth D (1998) Development of Competence in Favourable and
Unfavourable Environments. American Psychologist, February 1998.
McAuley C (1999) The Family Support Outcomes Study. Home Start UK/ Northern
Health and Social Services Board, Northern Ireland.
Maluccio A (ed) (1991) Promoting Competence in Clients: a New/Old Approach to
Social Work Practice. The Free Press, New York.
Parton N (1987) The Politics of Child Abuse. Routledge, London.
Perry BD (1993) Neuro-development and the neuro-physiology of trauma. The
Advisor 6(1): 1, 14–18; 6(2): 1, 14–20.
Pugh G (1999) Parents under Stress. Community Care, 2 –8 September 1999.
Reder P and Duncan S (1999) Lost Innocents. Routledge, London.
Reder P and Lucey C (1995) Assessment of Parenting: Psychiatric and Psychological
Contributions. Routledge, London.
Rosenfeld A A, Bailey R, Siegal B and Bailey G (1986) Determining incestuous
contact between parent and child: frequency of children touching parents’ genitals
in a non clinical population. Journal of American Academy of Child Psychiatry. 25:
Rushton A, Treseder J and Quinton D (1988) New Parents for Older Children. BAAF,
Rutter M (1974) Dimensions of Parenthood: some myths and some suggestions. In
Department of Health and Social Security (1974) The Family in Society: dimensions of
parenthood. HMSO, London.
Rutter M and Rutter M (1992) Developing Minds: Challenging and Continuity across
the Life Span. Penguin, Harmondsworth.
Rutter M (1996) Stress Research: Accomplishments and tasks ahead. In Haggerty R J
et al (1996) Stress, Risk and Resilience in Children and Adolescents. pp.354–386.
Cambridge University Press, Cambridge.
Rutter M (1999) Resilience concepts and findings: implications for family therapy.
Journal of Family Therapy. 21: 119–144, 159–160.
Schofield G (1998) Inner and outer worlds: a psychosocial framework for child and
family social work. Child and Family Social Work. 3: 57–67.
Schofield G and Brown K (1999) Being there: a family centre worker’s role as a secure
base for adolescent girls in crisis. Child and Family Social Work. 4: 21–31.
Seden J (2000) A Review of the Literature: Assessment in Social Work. In Department of
Health (2000b) Studies which inform the development of the Framework for the
Assessment of Children in Need and their Families. The Stationery Office, London.
Seligman M E P (1975) Helplessness: On Depression, Development and Death. W H
Freeman, San Francisco.
Shaw C (1998) Remember my messages . . . The Who Cares? Trust, London.
Sinclair R (1998) The education of children in need. Research in Practice/NCB,
Siporin M (1975) Introduction to Social Work Practice.Macmillan, New York.
Skinner B R (1974) About Behaviourism. Cape, London.
Social Exclusion Unit (1998) Bringing Britain Together: A National Strategy for
Neighbourhood Renewal. The Stationery Office, London.
Social Services Inspectorate (1999) Getting Family Support Right. Inspection of the
Delivery of Family Support Services.Department of Health, London.
Stevenson O (1998) Neglected Children: Issues and Dilemmas. Blackwell Science,
Thoburn J, Murdoch A and O’Brien A (1986) Permanence in Child Care. Basil
Thoburn J, Wilding J and Watson J (2000) Family Support in Cases of Emotional
Maltreatment and Neglect. The Stationery Office, London.
Thomas C and Beckford V (1999) Adopted Children Speaking. BAAF, London.
Tucker S, Tatum C and Frank J (1999) The Experiences of Former Young Carers. The
Children’s Society, London.
Tunstill J and Aldgate J (2000) Services for Children In Need: From Policy to Practice.
The Stationery Office, London.
Utting D (1995) Family and Parenthood: Supporting Families, Preventing Breakdown.
Joseph Rowntree Foundation, York.
Utting D (1996) Reducing criminality among young people: A sample of relevant
programmes in the United Kingdom.Home Office, London.
Ward H (2000) The Developmental Needs of Children: implications for assessment. In
Horwath J (ed) (2000) The Child’s World: Assessing Children in Need. The Reader. The
White M and Epston D (1990) Narrative Means to Therapeutic Ends. Norton, New
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
2 Assessing black children in need and their
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
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
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.
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
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
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
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
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
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.
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.
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.
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.
THEORIES AND PRACTICE INFORMING ASSESSMENT
Domain: Children’s Developmental Needs
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
• The extent to which the child and family have direct access to appropriate advice
support and services in relation to their health care needs;
• 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
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
_ 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
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
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.
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).
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
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.
Figure 4 A model of identity
Culture Religion Language
Gender Sexual identity
FAMILY AND SOCIAL
FAMILY AND SOCIAL
_ 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
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
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
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
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.
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
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
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.
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.
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
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.
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.
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
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
_ 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
• 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
• 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
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,
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
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
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
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
_ 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
• 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
Domain: Parenting Capacity
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
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
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
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
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
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.
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
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.
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
_ 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
2.117 The Childline study also highlighted racism experienced by children in their own
families. Comments from children calling Childline include:
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
• The extent of support, advice and intervention offered to the family, or the family
require, and how this can be provided.
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
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
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
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
• 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.
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.
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,
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.
_ 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
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;
_ 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
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
_ 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
• 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.
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
_ 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.
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.
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.
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.
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
2.162 The survey found also that:
_ the extent of poverty among both Pakistani and Bangladeshi households was
_ 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
(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
_ 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;
_ 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
_ 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
• 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.
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
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
_ 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.
Adams N (1981) Lambeth Directorate of Social Services. London Borough of Lambeth.
Arnold E (1975) Out of sight not out of mind. M.Phil, University of Sussex.
Atkin K (1996) An opportunity for change, voluntary sector provision in a mixed
economy of care. Race and Community Care. Open University Press.
Banks N (1992) Some considerations of racial identification when working with
mixed ethnicity children and their mothers as social services clients. Child
Development. 41: 49–67.
Barn R (1990) Black children in local authority care; admission patterns. New
Community. 16(2): 229–246.
Barn R (1993) Black Children in the Public Care System. Batsford, London.
Barn R (1999) White Mothers, Mixed Parentage Children and Child Welfare. British
Journal of Social Work. 29: 269–284.
Barn R, Sinclair R and Ferdinand D (1997) Acting on principle, an examination of race
and ethnicity in social services provision for children and families. BAAF, London.
Barter C (1999) Protecting children from racism and racial abuse. A research review. The
Batta I, Mc Culloch J and Smith N (1979) Colour as a variable in Childrens’ Sections
of Local Authority Social Services Departments. New Community. 7: 78–84.
Begum N (1992). Something to be proud of: The lives of Asian Disabled people and carers
in Waltham Forest. Race Relations Unit, London Borough of Waltham Forest.
Beresford B (1995) The needs of disabled children and their families. Findings from
social care research. No. 76. Joseph Rowntree Foundation, York.
Berrington A (1996) Marriage patterns and inter-ethnic unions. In Coleman D and
Salt J (eds) Ethnicity in the 1991 census. Vol 1, HMSO, London.
Bowlby J (1969) Attachment and Loss, Vol I, Attachment. Hogarth, London
Bowlby J (1973) Attachment and Loss, Vol II, Separation: Anxiety and Anger.Hogarth,
Bowlby J (1988) A Secure Base: Clinical Applications of Attachment Theory. Routledge,
The Bridge Child Care Consultancy Services (1991) Sukina; An evaluation report of
the circumstances leading to her death. The Bridge, London.
Butt J and Box L (1998) Family Centred. A study of the use of family centres by black
families. REU, London.
Butt J and Mirza K (1996) Social care and black communities A review of recent research
studies. HMSO, London.
Carter H (1998) A joined-up solution to poverty. Voluntary Voice No.129. London
Voluntary Services Council (LVSC), London.
Cashmore E (1984) Dictionary of Race and Ethnic Relations. Routledge, London.
References – Chapter 2
CCETSW (1996) Children, Spirituality and Religion. A Training Pack. Central
Council for Education and Training in Social Work, London.
Childline (1996) Children and racism. Childline, London.
Cross W E (1971) The Negro-to-Black Conversion Experience: Towards a Psychology
of Black Liberation. Black World. Volume 2.
Donald J and Rattansi A (1992) Race, Culture and Difference. Sage, Bristol.
Dosanjh J S and Ghuman P A S (1997) Child Rearing Practices of Two Generations of
Punjabi Parents. Children and Society. 11: 29–43.
Dosanjh J S and Ghuman P A S (1998) Child Rearing Practices of Two Generations of
Punjabi Parents: Development of Personality and Independence. Children and Society.
Dutt R and Phillips M (1996) Report of the National Commission of Inquiry into the
Prevention of Child Abuse. Volume 2, Background Papers. The Stationery Office,
Erikson E (1968) Identity, Youth and Crisis.Norton, New York.
Farmer E and Owen M (1995) Child Protection Practice. Private Risks and Public
Remedies. HMSO, London.
Finkelhor D (1986) A sourcebook on child sexual abuse. Sage, London.
Gibbons J, Conroy S and Bell C (1995) Operating the child protection system. HMSO,
Grant L (1996) Parenting in Black Families. The Parenting Forum Newsletter No.5.
Haskey J (1997) Population Review (8). The ethnic minority and overseas-born
population of Great Britain, Population Trends No. 88. Office of National Statistics,
Hoghhughi M and Speight A (1998) Good enough parenting for all children – a
strategy for a healthier society. Archives of Diseases in Childhood. 78: 293–300.
Hylton C (1997) Family survival strategies. Exploring Parenthood.
Jones T (1993) Britain’s Ethnic Minorities. Policy Studies Institute, London.
Jones E and McCurdy K (1992) The links between child maltreatment and
demographic characteristics of children. Child Abuse and Neglect, Vol 16.
Katz I (1996) The Construction of Racial Identity in Children of Mixed Parentage. Mixed
Metaphors. Jessica Kingsley, London.
Klaus H and Kennel J (1976) Maternal Infant Bonding. Mosby, St Louis.
Kundnani H (1998) The sanction of last resort. Voluntary Voice. No.129. London
Voluntary Services Council, London.
London Borough of Lambeth (1987) Whose Child? The Report of the Panel of Inquiry
into the Death of Tyra Henry 1987. London Borough of Lambeth.
Macdonald S (1991) All Equal Under the Act? National Institute for Social Work,
MacPherson W (1999) The Stephen Lawrence Inquiry. Report of an Inquiry. The
Stationery Office, London.
Milner D (1983) Children and Race Ten Years On. Ward Lock Educational, London.
Nazroo J Y (1997) The Health of Britain’s ethnic minorities. Findings from a national
survey. Policy Studies Institute, London.
NHS Executive (1998) Sickle Cell Anaemia.Department of Health, London.
Office for National Statistics (1996) Social Focus on Ethnic Minorities. HMSO,
Owen (1992) Ethnic Minorities in Great Britain: Settlement Patterns, 1999. Census
Statistical Paper No 1. Centre for Research in Ethnic Relations, University of
Owusu-Bempah J and Howitt D (1997) Socio-genealogical connectedness,
attachment theory and child care practice. Child and Family Social Work. 2: 199–207.
Owusu-Bempah K and Howitt D (1999) Even their soul is defective. The Psychologist.
Phaure S (1991) Who really cares? Models of voluntary sector community care and black
communities. London Voluntary Services Council, London.
Prohansky H and Gottleib N (1989) The development of place identity in the child.
Zero to Three. X: 2, pp.18–25.
PSI (1997) The Fourth National Survey of Ethnic Minorities in Britain, Diversity and
Disadvantage. PSI, London.
Reder P, Duncan S and Gray M (1993) Beyond Blame, Child Abuse Tragedies Revisited.
Rowe J, Hundleby M and Garnett L (1989) Child Care Now. British Agency for
Adoption and Fostering. Research Series 6.
Rutter M (1972) Maternal Deprivation Reassessed. Penguin, Harmondsworth.
Schaffer H and Emerson P (1964) The Development of Social Attachments in
Infancy. Monographs of Social Research in Child Development. 29: 94.
Sinclair I and Gibbs I (1998) Children’s Homes: A study in Diversity. Wiley, Chichester.
Smaje C (1999) Health, Race and Ethnicity. Making sense of the evidence. Kings Fund
Social Exclusion Unit (1998) Bringing Britain Together: A National Strategy for
Neighbourhood Renewal. The Stationary Office, London.
Social Services Inspectorate and Surrey County Council (1995) Unaccompanied
Asylum-Seeking Children: A Training Pack. Department of Health, London.
Swanick M (1996) Child Rearing across Cultures. Paediatric Nursing. 8(7): 13–17.
Thomas L (1995) Multi-cultural Aspects of Attachment. Internet.
Thoburn J, Lewis A and Shemmings D (1995) Paternalism or partnership? Family
involvement in the child protection process. HMSO, London.
Tizard B and Phoenix A (1994) Black, White or Mixed Race; Race and Racism in the
Lives of Young People of Mixed Parentage. Routledge, London.
Troyna B and Hatcher R (1992) Racism in Childrens’ Lives; A Study of Mainly White
Primary Schools.National Childrens Bureau/Routledge, New York.
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
… 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
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
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).
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
_ 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).
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
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
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
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
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
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.
Children who acquire their impairments may come suddenly into contact with all
three agencies. Children with progressive conditions may have to switch between
services and agencies as their needs change.
3.26 Within agencies, responsibilities for assessments of disabled children may also be
located in different teams. For example, specialist social work teams for the deaf are
often in either the disability or adult divisions, yet families obtain services from child
care social workers or workers located in children with disabilities teams. Working
across these boundaries can be facilitated by the development of a culture of coworking
to harness all available expertise when assessing disabled children.
3.27 Gather information from existing assessments. Disabled children are likely to have
already been assessed, and information already gathered should be accessed, having
obtained consents as appropriate. Parents find it hard to tell their story again and again
(Department of Health,1998b, p.22). Both children and family members often
assume that agencies will share information with each other and may be surprised to
find that they do not. Parents and children can be asked who they think has the most
relevant knowledge – many have reported thinking the wrong professionals were
consulted (Russell, 1999).
3.28 Integrated inter-agency assessment processes are in place in some areas and being
developed in others (Russell, 1995; McConahie, 1997; Khan and Russell, 1999).
Cross-agency key working can also enable effective information sharing (Mukherjee et
al, 1999). Even where these mechanisms are not yet in place, information from other
assessments should be available. For example, the Code of Practice on the Identification
and Assessment of Special Educational Needs (Department for Education and
Employment, 1994) requires local educational authorities to send a copy of the final
statement of a child’s special educational needs and accompanying advice to the social
services department, whether or not social services have provided advice during the
assessment process. It is good practice to seek parent’s permission to send information
to other agencies but where there are concerns about a child’s safety local authorities
may transfer information in the best interests of children without formal permission
(see Working Together to Safeguard Children 1999, paragraphs 7.27 to 7.46).
3.29 Access helpful information on specific childhood impairments. It may be important
to learn in general about the likely effects of an impairment or condition before
meeting a child and his or her family. As a disabled teenager reported in Cross (1998)
I wish they knew more about disability, I mean, its sort of embarrassing to have to
explain yourself (p.102).
3.30 Learning about a child’s condition does not mean becoming an expert. There are
organisations of and for people with almost all impairments and conditions, and for
parents. These are often good sources of accessible and up-to-date information1. It is
important however to remember that every child experiences their condition
differently. It will be important to understand the impact of an impairment on this
child in this family as part of an assessment. Usually the be