children's wellbeing in care – evidence from a longitudinal examination of outcomes dr...
TRANSCRIPT
Children's Wellbeing in Care – Evidence from a Longitudinal Examination of Outcomes
Dr Elizabeth FernandezSchool of Social Work
University of New South [email protected]
Presented at the Association of Child Welfare Agencies Conference Incorporating the 7th International Looking
After Children Conference August 14-16, 2006‘Positive Futures; Achieving wellbeing for Children
and Families’
Children’s Conceptions of Fostering
• What is a foster home?: "Places of refuge where people can stay, where you get looked after.” Would you call this home a foster home?: "No, this is my house.” (009, male, 11 years old)
• Would you call yourself a foster child?: "Not really, I wouldn't call myself one cause my carer treats me as her own son, even though she's already got one and she's already got a daughter but she treats me as her own son. And I really adore her.”
• “No a normal kid like everyone else. Because here it is like a real family. Some parents don’t care about children, that’s why I came into foster care.” (005, male, 12 years old)
Children’s Conceptions of Fostering (cont’d)
• “A person who acts like your mum and dad, I haven’t got my mum and dad or my brother or the pets that I had before. That’s why it’s not the same. You’re in somebody else’s house and it’s not your real mum and dad but it’s the person that’s looking after you for the moment.” (female, 8 years old)
• “Sort of because they miss their mum and they really want to go back to her, and they won’t be able to see her for a long, long time, so they act differently because of this. But once they settle in they get fine, and then um they just forget about it and start moving on.” (male, 9 years old)
The impact of the care experience on children’s wellbeing
• Children come to the foster family setting as an already at risk group
• In relation to children's wellbeing in care research has identified a range of concerns including
• Instability in care placements (Barber & Delfabbro, 2003; Fernandez, 1999; Pecora, Williams, Kesler & Herings, 2003; Ryan and Testa, 2004)
• Inability of care systems to ensure optimal educational outcomes (Jackson, 2000;Dobel-Ober, Lawrence, Berridge & Sinclair, 2003; Rosenfeld & Richman, 2003; Zetlin, Weinberg & Kimm, 2003)
The impact of the care experience on children’s wellbeing
• Children’s vulnerability to physical and emotional difficulties while in care ( Flynn, Ghazal, Legault, Vandermeulen & Petrick, 2004; James, Landsverk, Slymen & Leslie, 2004
• Risk of losing attachments to their biological families (Cleaver, 2000; Kufeldt et al, 2003)
• The Looking After Children Initiative (Ward, 1995) emphasises key dimensions of optimum care to be expected from out of home care such as health, education, emotional and behavioural development and family and social relationships
The impact of the care experience on children’s wellbeing
• Current research points to limitations of cross sectional studies in capturing developmental sequences
• Increasing recognition of the need to give a central place to the voices of children in research and practice (Gilligan, 2002; Newman, 2003)
• Limited research that views outcome from different participants in the foster care process (Courtney, 2000; Kelly & Gilligan, 2002)
The Research Aims
• To document the needs and experiences of children in care from the perspective of their carers, case workers, birth parents and children themselves
• To explore children’s perceptions of their developing relationships with foster families, and their established relationships with their birth family and significant others
• To analyse the perceived adjustment and psychosocial functioning of children over the study period and document placement and developmental outcomes
The Research Aims (cont’d)
• To further understanding of the risk and protective factors affecting the children's physical and psychological health, their interpersonal relationships, and their educational and social development
• To establish how the children and their carers experience social work support, and the impact of professional input on outcomes
Data Collection
• Interviews were carried out at 4 months after entry to care and 18-24 month intervals thereafter
• Child interviews (8 – 18 yrs)
• Caseworkers (of children of all ages)
• Foster/adoptive carers (of children of all ages)
• Birth parents (of children of all ages)
Interviews Explored
• Conceptions of fostering• Child’s placement history• Reasons for entry to care• Relationship with the carer and foster siblings• Relationship with the birth family• Schooling experience• Physical health• Emotional and behavioural development• Identity and self image • Relationship with caseworker and agency
Data Collection (cont’d)
Measures used in the study• Looking after children AAR subscales
(completed by caseworkers and children)• Achenbach CBCL (completed by carers)• Achenbach TRF (completed by teachers)• Hare self esteem scale (completed by children)• Interpersonal parent and peer attachment scale
(completed by children)• Attachment styles questionnaire (completed by
carers)• Foster care alliance scale (completed by
children and carers)
What was measured?Table 1: Psychological variables assessed
1. Looking After Children Assessment & Action Records
These emotional and behavioural development scales have evolved from original AARs to provide six subscales and one total score for children in care. The children were asked about 30 feelings or behaviours “which young people might feel or act sometimes”. Items were both negatively and positively phrased. The children were asked to say whether each skill was “a lot like me”, “quite like me”, “a bit like me” or “not at all like me” .
What was measured? (cont)
LAC Subscales •Emotional problems•Conduct problems•Over activity•Peer relationships•Pro-social disposition•Carers
Fears, unhappiness, depression
Fighting, destructiveness, stealing
Restlessness, failure to settle to tasks, poor concentration
Popular, finds it hard to mix, shares, lets others join in
Positive behaviour toward others
Trusts and confides, goes for reassurance, likes affection
What was measured? (cont)
2. Profile of dominant positive and negative emotions
The children were asked how often they experienced a range of 12 positive and negative emotions (eg. sadness, anger, happiness, excitement)
3. Cohesion with foster family members
The children were asked to describe “how well they got on” with different members of their foster family, including the foster mother, father and any children.
What was measured? (cont)
4. Hare Self-Esteem Scale (HSS)
The HSS has three subscales to assess peer Self-Esteem, Home Self Esteem and School Self-Esteem and a Total Score. Measured at Interview 2 and 3.
5. Inventory of Parent and Peer Attachment (IPPA),
The IPPA assesses a child’s level of attachment to his or her mother, father and friends or peers. There are three subscales – trust, communication and alienation and a total attachment score. Interviews 2 and 3
Factors Affecting AdjustmentVariables from the children’s interviews analysed were:• placement variables (total number of placements and time in care • contact with birth family members• cohesion with foster family members.• Feelings and emotions• LAC: 6 Subscales and relationship skillsVariables from the caseworkers’ interviews analysed were:• academic progress, • health, • overall adjustment, • satisfaction with how the placement is going overall.• number of positive life events (total, total attachment events, total achievement
events), and whether there is a stable foster placement• length of time with the current carer• assessment of carers’ parenting styles:
– responsiveness in relation to the emotional needs and demands of the child– ability to express warmth towards the child– ability to respond sensitively– ability in relation to managing the child– disciplinary style or level of aggression in parenting
About the Children • 59 children participated in the study• Boys 52%• Girls 48%• Ages ranged from 3 to 15• 12 years was the most frequently occurring age • Children are from Barnardos Find-a-Family Centre,
an integrated service of permanent family care and adoption for “hard to place” children requiring long-term placement. Many have multiple failed placements prior to their Find-a-Family placement and, almost none have adoption care plans on entry
Care History
• Total placements – A third of the children had more than 5
placements in total including pre Barnardos care history
– The median number of placements was 4 placements and the average was 4.3 placements
– Time in care was strongly related to number of placements (r=0.58, p=0.000)
– Half the children have been in their current placement for four years or more
Time in Current Placement
0
5
10
15
20
25
30
35
40
45
50
2 yrs or less 3 - 4 yrs 5+ yrs
Time in Current Placement (Base = 42)
Pe
r c
en
t
Per cent
Care History
• Respondents have been in care for 8.2 years on average and have been in Barnardo’s care for the majority of that time (6.3 years). Respondents have had on average 4.4 placements in total and 3.1 placements through Barnardo’s. The average age for entry to Barnardos’ care is 3.5 years old
• Males have spent longer in care on average (9 years) than have females (7.4 years)
• The majority (71%) of respondents are in non relative foster families and a further 19% are adopted
Change of Placement and Children’s Responses Many of the children interviewed had multiple carers over
time. Children’s placements ranged from 2 to 7 foster homes, an irony that is presented by one of the children when asked why they thought they were in care
• ‘Ah, cause we've moved around a lot’ (006, male, 11yrs)
Many children were aware that they would eventually find a permanent foster placement, even though they were not sure how long their present placement would last
• ‘(SIGH) well if I am very very, extremely good I might stay here and this might be my forever family but if um, if this isn’t a good place I will have to move, which I don’t want to’ (039, female, 8 yrs)
• ‘ (Until) I'm old enough to move out into a flat’ (007, female, 11yrs)
Foster Parent Cohesion• Forty-eight per cent of respondents indicated they
got on 'very well' both with their foster mother and their foster father.
• All but one respondent indicated that they got on with their foster mother ‘very well’ or ‘quite well’
• Almost 9 out of 10 respondents were positive about their relationship with their foster father, rating 'very well' or 'quite well‘
• Just over 1 in 10 respondents indicated that they got on with their foster father 'not very well'
• Eighty-six per cent of respondents were positive about their relationship with their foster sibling
• However nearly 1 in 10 respondents indicated that they got on with their foster sibling 'not very well'
Foster Mother Cohesion & Foster Father Cohesion
0
10
20
30
40
50
60
70
80
Very Well Quite Well Not Very Well & Don't Know
Cohesion (Base = 42)
Pe
r c
en
t
Foster Mother
Foster Father
Children’s perceptions of cohesion
• The relationships with the foster mothers remained very positive, especially amongst boys and younger children
• Children who had a stronger level of maternal attachment were more likely to sustain highly cohesive relationships within the foster families
• The higher the cohesion with the foster mother the higher the cohesion with the foster father (r=0.37, n=40, p=0.021)
• Age was significantly related to cohesion with the foster father (r=0.5, p=0.01) such that older children were less likely to report getting on “very well” with the foster father
Children’s perceptions of cohesion (cont’d)• The child’s cohesion with other children from the
foster family, was significantly related to the child’s number of placements
• Children who got on very well with the children of the foster family had significantly fewer placements than children who did not get on very well (p= 0.018)
• There were significant relationships between the child’s self reported relationship building skills and cohesion with the foster mother (r= -.69, p<0.01) and the foster father (r= -.63, p<0.05). The more perceived skills at Interview 1, the more cohesive the relationships at Interview 2.
Cohesion with Foster Mother – Foster Father In general the children manage to have good
relationships with their carers. Some relationships are harmonious yet others seem to be very good
Q. ‘What is it like living here, with (Carer)’• Well, they have a pool, and um . . . I just like living
here, cause I get to do some hammering and nailing if I want to …and it is actually fun, and I get to do ironing, it is GREAT!.. She is kind, lovely, beautiful, sweet, cute . . . like an angel’ (039, female, 8 yrs)
• “Good, everything is good. I want to stay here until I have money to buy a house.” (015, male, 10 yrs)
Cohesion (cont)
• ‘She's (female carer), understanding, she's nice. She helps me with lots of things. She’s just a very kind person she's got a nice heart…sometimes I give a hug to (carer) before I go to bed…I don't know what's the most important thing. When I go shopping with her, just me and her by ourselves we just talk you know. I like how we have time by ourselves sometimes’ (female, 17yrs)
• ‘She, umm, she'll spend lots of time on me and she's really nice, and…she helps me with things when I need help...she always has the right advice to tell me...cause they treat me like I’m part of the family so I think I am’ (female, 10yrs)
The Inventory of Parent and Peer
Attachment (IPPA) • The IPPA, was administered at Interviews 2 and 3 to
assess each child’s level of attachment to his or her current foster mother, foster father and friends or peers.
• There are three subscales – trust, communication and alienation and a total attachment score
• A higher score indicates greater attachment • T-tests were used to compare the each child’s scores at
these two interviews on the IPPA three subscales – trust, communication and alienation and a total attachment score.
• The analyses indicated statistically significant changes in the children’s ratings for maternal and peer attachment but not for paternal attachment
Changes in IPPA scores from Interview 2 to Interview 3 for all children
Interview 2 Interview 3
Mean Std Dev Mean Std Dev sig
Maternal Attachment
Alienation 22.5 3.4 25.8 3.4 p=0.001
Communication 23.1 3.5 23.9 4.3 ns
Trust 28.2 4.0 33.2 5.0 p=0.000
Total 91.2 12.6 102.7 15.8 p=0.008
Paternal Attachment
Alienation 23.0 3.6 23.66 5.4 ns
Communication 23.3 3.0 22.7 5.9 ns
Trust 28.5 4.3 31.0 6.9 ns
Total 91.3 12.4 95.3 22.4 ns
Peer Attachment
Alienation 22.1 4.7 24.0 5.2 ns
Trust 33.5 6.1 37.6 6.1 p=0.023
Communication 27.0 5.0 31.3 5.8 p=0.002
Total 85.7 15.7 96.7 15.4 p=0.013
The Inventory of Parent and Peer Attachment (IPPA) (cont)
• Children reported better maternal attachment trust and communication, and overall peer attachment.
• Indicates that the children are feeling more settled in their relationships with their foster mother and the same aged children
• No progression or deterioration in the children’s feelings of attachment toward their foster father
• Boys reported improved scores on three maternal attachment scores, including alienation, trust and the total score. They also showed and significantly improved scores on all the peer attachment scores.
The Inventory of Parent and Peer Attachment (IPPA) (cont)
• Younger children had stronger maternal trust and better peer communication at Interview 3.
• The teenage children had improved maternal alienation scores, better maternal trust and improved total maternal attachment scores. Additionally older children had significantly better peer communication scores. There were no changes in paternal attachment scores.
The Inventory of Parent and Peer Attachment (IPPA) Summary of Changes
• The changes were in a positive direction and not signalling deterioration and lend some support to the benefits of the children’s time in care.
• Most encouragingly the strongest changes were observed for boys and for older children
• Older children and boys were “catching up” to the girls and younger children on some of these variables
Relationships between IPPA subscales
• Children’s responses to the maternal and peer subscales are closely inter-related
• Responses to the Paternal Attachment questions, however were only related to each other and not to the other two sets of subscales
• Children’s attachment to their peers and foster mothers were based on similar judgements but children thought in a different way when considering their attachment to their foster fathers
Birth Parent Contact
0
10
20
30
40
50
60
Once a Month orless
Quarterly/Holidays Annually Never
Contact (Base M=39; F=32)
Pe
r c
en
t
Birth Mother
Birth Father
Contact with Birth Parents
Frequency of Contact
• Birth Mothers and siblings were the most frequently contacted family members
• One child in 5 had contact with his or her birth mother at least fortnightly
• Nearly three-quarters of children (72%) saw their birth mother at least once every 3 months
• A quarter had no contact at all• Just over half (56%) of the children had no
contact at all with their birth father• 28% saw their father between once a month and
every few months or holidays
Frequency of Contact (cont)
• Grandparents were an occasional point of contact
• 26% of children confirmed contact with their maternal aunt
• 4 children in 10 had ongoing contact with their previous carers
• Nine in ten (90%) respondents report that since the last interview they have had some contact with their siblings who are not living with them. One in four had contact either monthly or fortnightly with them
Children’s desired contact with their birth family
0
10
20
30
40
50
60
70
More Same Less Not at all
Mum Dad Siblings
Children’s Connection to their Birth Mother‘…they say that she's not a proper Mum’. (006, male, 11yrs)
Children throughout the interviews seem very connected to their birth mother. The children in the main have a desire to live with their mothers or would choose to confide in their birth mother if they were having any difficulties, although the foster mothers were also noted as a confidante.
Q. ‘Suppose you had a problem…who would you most like to talk to’?• ‘Um, my mum or Susan’. (His foster mother) (003, male, 12yrs)
Both the above child and his younger brother expressed clear and positive connections with their birth mother yet could also evaluate the positive aspects of the new home.
• ‘I want to live with my mum but I like the school and that ...And mum couldn't pay for the school, so I'll live here, but I probably want to live with my mum’ (003, male, 12yrs)
Q. How do you feel when you see her? (Birth Mother)• ‘Happy…Mmm, I dunno I just have this feeling…Mmm,
nice, mmm happy, mmm that's about it’ (006, male, 11yrs)
• ‘Um, the fact that I'm happy’ (007, female, 11yrs)• ‘I’m always missing my mum. It doesn't happen that
much now, cause I see her every month’ (male, 13yrs) • ‘I ask her a lot of questions, I ask her what was she like
when she was little, what was I like when I was little…Just to see her…She realises what she's done and she tried to change but that's her’ (female, 17yrs)
• ‘Most of the time she doesn't turn up…She might turn up every second time….She's heaps nice. And she never laid a hand on me’ (male, 14yrs)
Current Contact with Family of Origin
Current Contact with Family of Origin (cont)
• Compared to Interview 1, the only significant change was an increase in children’s desire to see their fathers
• Many of the children expressed that they never see their birth fathers, they did however appear to be interested in seeing them and establishing a connection
• ‘…I'd like to see him (father) a lot more, heaps and heaps and heaps more times, it makes me feel happy’(female, 8yrs)
• ‘I don’t have a real dad, I never did. I only have false dads’ (female, 8yrs)
• ‘I’ve never had a first dad’ (male, 11yrs)
Hare Self Esteem Scores (HSS) compared to normative data
76
78
80
82
84
86
88
90
92
Norm Boys Girls All
Children’s Interviews• Children’s self esteem was assessed using the hare
self esteem scale. Includes peer self-esteem, home self esteem and school self-esteem and a total score
• Girls and boys both had an average of 82• Peer self esteem was negatively correlated with total
number of placements, (r= -0.42, p=0.05) so that the more placements children had the lower their peer self esteem
• Age at entry to care was also found to be related to “global self esteem” (r=0.37, p=0.05). That is, children who went into care at an older age had higher self esteem at interview 2
Hare Self Esteem Scores, including gender breakdown
• Girls were found to have remained stable from Interview 2 to Interview 3 on all the subscales and the total self esteem score
• Boys however had significantly higher home self esteem scores and total self esteem scores at Interview 3 compared to interview 2.
• This finding is encouraging given the small sample sizes and indicates that boys responded positively to the foster home environment.
Self esteem and Children’s care history
• From the children’s interviews it was apparent that being in care affected their self esteem. However, the children did also compare themselves to their peers for some reassurance.
• ‘It’s like we're second hand kids; unless that's how all kids feel who are my age…’ (female, 12yrs)
• ‘When I see my friends with their parents I see nothing different...it just seems the same, like I’ve got play stations and Nintendo’s, and being allowed to play and going to friends houses as well’ (male, 13yrs)
• ‘Some people in my class don't even have a dad. And I get lots of stuff’ (female, 10yrs)
• When children were asked what they most liked about themselves were, many of the children appeared to have a positive response.
• ‘I’m a loving and caring person. And I’m hopeful’ (male, 13yrs)
• I’m creative, I’m intelligent. I don't know…I’m gentle, I’m caring, I’m nice to people’ (female, 9yrs)
• ‘I don't know I’m good at sport…happy most of the time, I’m just happy’ (male, 12yrs)
• ‘If I do things I keep tying and trying. And if I can’t do it I keep trying’ (male, 11yrs)
Q. Imagine you could change something about yourself, would you change anything?
• “No, because my mum wouldn’t recognise me.” (035, male, 8 yrs)
Identity and Self Image
Strong negative emotions experienced by children at separation and in the 3 months prior to Interview 3 Rank Feeling Int 3
(%)
Separation
(%)
1. Angry 31 34
2. Worried 31 50
3. Sad 52 64*
4. Not at all Excited 10 58 **
5. Not at all Happy 17 58*
6. Nervous 40 36
7. Lonely 40 50
8. Helpless 31 24
9. Scared 38 50 *
10. Embarrassed 31 28
11. Guilty 26 24
p < 0.01; ** p < 0.001
Emotions experienced
• Most commonly experienced feeling across all categories was sadness
• Majority of boys also reported feeling worried (57%)
• Majority of girls felt lonely (60%)• Girls were more likely to feel very angry than
boys at the time of separation • Younger children were more nervous• Their overall distress included multiple
emotions like being very worried, scared, angry and lonely simultaneously
• Children were significantly happier, less scared and more excited at interview 3
Looking After Children Assessment & Action Records
The rating scale yielded six subscales Emotional problems Fears, unhappiness, depression
Conduct problems Fighting, destructiveness, stealing
Over activity Restlessness, failure to settle to tasks, poor concentration
Peer relationships Popular, finds it hard to mix, shares, lets others join in
Pro-social disposition Positive behaviour toward others
Carers Trusts and confides, goes for reassurance, likes affection
Children’s scores on LAC subscales at Interviews 1, 2 and 3 and normative data from a comparable group of 100 children in care (UK) and Children in care at Barnardos Interview 3 Interview 2 Interview 1 UK
Mean Mean Mean Mean
Conduct 2.9 3.2 4.1 3.4
Emotional 3.8 5.2 7.2 3.8
Overactive 4.7 5.4 5.5 4.7
Peers 2.4 2.8 3.3 2.9
Pro Social 9.4 9.0 8.5 8.4
Relationship
with Carers
2.9 3.2 4.6 3.4
Total Score 17.7 20.1 24.8 19.2
Children’s scores on LAC subscales at Interview 1, 2 & 3
• Significant improvement in the children’s ratings of emotional problems
• Girls had significantly higher pro social scores which indicates a more positive social skill set than boys
• Girls also reported having more carer problems than boys
• Older children being were likely to have more conduct problems (r=0.54, p=0.003)
Relationship building skills reported by children at Interview 1
% %
Let others join in 88 Not often angry and lose temper
59
Not over friendly with others
85 Not extremely suspicious of motives
50
Considerate of other’s feelings
81 Not often in trouble 46
Like to share 77 Able to trust 41
Do not find it hard to mix with young people
75
Do not get into fights 70 Relationship with Carers
Comfort others who are upset
69 Like carer’s to show physical affection
70
Easy to make and keep friends
67 Not impatient with carers 67
Popular with young people
63 Get reassurance from carers 48
Frequencies for each positive relationship skill for Interviews 1, 2 and 3 LAC child’s self-assessment.
Interview 3
%
Interview 2
%
Interview 1
%
1. like to let others join in the things they are doing
92 84 88
2. comfort other people who are upset 88 81 69
3. are considerate of other people’s feelings 85 85 81
4. does not get into fights or pick on other young people
85 85 70
5. like to share things with others 81 77 77
6. find it easy to make and keep close friends 81 77 67
7. not extremely suspicious of other people’s motives
78 65 50
8. are popular with other young people 78 73 63
9. does not find it hard to mix with other young people or are shy
78 69 75
10. not overfriendly with people they don’t know well
76 77 85
11. feel able to trust and confide 73 58 41
12. does not often show they are angry and lose their tempers
73 64 59
13. not often in trouble for being disobedient, defiant or disruptive in school, TAFE, work or home
57 65 46
Relationship with carers
1. do not get impatient and demanding with their carers
78 54 67
2. like their carers to show them physical affection
71 65 70
3. go to their carers when they need reassurance 71 62 48
Relationship skills
• At Interview 3, 11 skills were reported by more than 75 per cent of the children, an increase of six skills from Interview 1 and four from Interview 2
• At Interview 3 more children were reporting feelings of trust, confidence amongst their peers and less demanding with their carers
• Several behaviours did not improve very much from Interview 2 to 3 including ‘comfort others who are upset’, ‘considerate of other’s feelings’, ‘not getting into fights’, ‘sharing’, ‘ability to make friends’
LAC Scores and Cohesion
• A positive correlation exists between the number of reported relationship skills and the level of cohesion with the foster mother (r=0.42, n=42, p=0.006) and the foster father (r=0.38, n=42, p=0.014).
• Cohesion also relates to some LAC subscales • The greater the foster mother cohesion the fewer relationship
problems with carers (Carer Subscale: r=-0.41, n=42, p=0.006)
• The greater the foster father cohesion the fewer relationship problems with carers (Carer Subscale: r=-0.36, n=42, p=0.020), the fewer the conduct problems
• The nature of the relationship with the foster father at interview 1 appears to have had an important developmental influence on the children, so if there was very good cohesion the child increased their relationship skills by interview 2 & 3
Concentration and behaviour problems LAC child’s self-assessment. Interview 3
%
Interview 2
%
Interview 1
%
1. Rush into things without thinking 45 42 41
2. Do not find it easy to concentrate
when they want to
28 44 39
3. Find it difficult to stick to things for
more than a few moments
28 44 31
4. Are very restless and fidgety 28 40 35
5. Not responsible and can not be
trusted
7 12 12
6. Deliberately break or steal things 0 8 0
Most frequently the children reported rushing into things without thinking.
Frequencies for each anxiety symptom from Interview s 1, 2 and 3 LAC child’s self-assessment.
Interview 3
%
Interview 2
%
Interview 1
%
1. Worry a lot 38 27 56
2. Often get aches and pains (including
headaches, stomach aches)
23 19 48
3. Have a very poor appetite or are concerned
about dieting
19 23 32
4. Have difficulty in sleeping because of worry or
anxiety
16 32 44
5. Have strong feelings of misery or sadness 14 38 54
6. Are frightened of particular things or situations
(e.g. open spaces, going to school/TAFE or
being alone)
14 42 40
7. Sometimes wet the bed 4 0 0
8. Deliberately injuring themselves (e.g.cutting, or
taking an overdose)
2 15 4
Anxiety problems
• ‘Worrying a lot’ was the most frequently reported symptom: over a third of the children reported this
• Nearly a quarter of children reported anxiety-related somatic complaints
• Females appeared to have more anxiety problems on average than did males (t(40)=-1.95, n=40, p=0.058)
• Just under a third of children experienced multiple anxiety symptoms at the time of the third interview
• Improvements at interview 3 were in relation to reduced feelings of misery and sadness, fears and sleeping difficulties
Caseworker Assessments Of Child’s Adjustment
• Caseworkers were asked to rate how satisfied they were with the ‘way things are going for the child’ on a 5-point scale where ‘1’ is ‘not at all satisfied’ and ‘5’ is ‘very satisfied’
• Just over three-quarters are ‘very satisfied’
• 6% are ‘not at all satisfied’
• Greater average satisfaction ratings were recorded for younger (4.8) than older children [t(35)=1.95, p=0.059].
Caseworker satisfaction with 'how things are going' for the child (Base=51)
18% Satisfied77% Very satisfied
6% Not at all satisfied
Caseworker Assessments Of Child’s Adjustment (cont)
• Caseworkers were asked to rate the child’s adjustment on a 4-point scale where 1= ‘poor’ and 4= ‘excellent’.
• Caseworkers rated 84% of children’s adjustment as ‘excellent’ (40%) or ‘adequate’ (44%).
• ‘mixed’ (10%) or ‘poor’ (6%) adjustment. • Younger children were rated as having
better adjustment than older children [t(34)=3.3, p=0.002].
Children’s adjustment to placement across time
Adjustment Year 1 Year 2 Year 3 Year 5 Year 6
% % % % %
Excellent 17.5 40.6 58.3 54.5 40
Adequate 40.0 28.1 29.2 45.5 44
Mixed 32.5 21.9 12.5 10
Poor 10.0 9.4 6
Adjustment to placement over time
• The proportion of children in placement with excellent adjustment grows with time
• 17.5% to 58.5% in year 3
• 54.5% in year 4
• Mixed or poor adjustment decreases from 42.5% in year 1 to 16% in year 6
Caseworkers ratings of child’s academic progress
• Caseworkers were asked to rate the child’s academic progress over the last 2 years. Three-quarters (75%) were rated as progressing very well (19%) or moderately well (55%). Approximately a quarter (26%) of children were rated as progressing ‘not very well’. There were no age or sex differences
Friends / Change of Schools
When asked to evaluate how they were doing at school, most children attempted to asses their own abilities.
• ‘Um, playing and English. I'm not so good at my maths’ (007, female, 11yrs)
• ‘Hand writing everything. Not everything in the world though…I'm good at mostly everything’ (017, female, 8yrs)
• ‘…can't hardly read…and plus I'm year 5 going in year 6…can't even hardly read or do neat writing…’ (008, female, 10 yrs)
• Um, middle of the class. I mean, we got graded and it goes up to A's and I'm in the…(middle)’ (003, male, 12yrs)
Length of time with the current carer
• Those children who have been with their carers for at least 3 years have, on average, better academic adjustment and better overall adjustment [t(45)=-3.56, p=0.001]
• And better health [t(44)=1.98, p=0.054]
Positive life events
Per cent ‘Yes’
Per cent ‘Yes’
Achievements Stable foster placement
Educational achievements 52 Stable foster placement 78 Sports or athletic achievements 48 Other recreational activities (eg music/ art)
44 Job/ Culture
Trips, vacations 76 Job/ employment 14 Having a pet 48 Attachment Other Bond with birth parent 32 Developmental
achievements 52
Bond with previous caregiver 8 Participation in significant family events
65
Bond with present caregiver 72 Move to emotionally healthier environment
33
Significant Other attachment 30 Better health 18 Visiting siblings, birth parents, extended family
50 Healing (emotional, psychological)
29
Friendships 62
Positive life events
• 94% of children had at least one of the five listed ‘achievement’ life events
• 48% had had two or three such events • 92% of children had at least one of the six
listed ‘attachment’ life events • 52% had had two or three such events• Caseworkers rated 90% of children as
being in ‘excellent’ (41%) or ‘very good’ (49%) health
Positive Achievements and Critical Events • Most frequently reported was having a stable foster
placement (78%)• Three quarters of the children (76%) were able to go on
a trip or vacation• Development of relationships with carers, new friends
or birth family was also common, experienced by two thirds
• Many children experienced some level of educational achievement (52%) or sporting achievement (42%)
• The most frequently reported critical or crisis events reported included the experiences of bullying, emotional abuse and violence or physical abuse
Positive life events • The greater the total number of positive life events the better
the academic adjustment (r=0.42, p=0.003), health (r=0.38, p=0.007), and the better the caseworker’s overall adjustment assessment for the child (r=0.34, p=0.016)
• The greater the positive achievement life events the greater the academic adjustment (r=0.58, p<0.001), health (r=0.43, p=0.002) and overall adjustment ratings (r=0.38, p=0.008)
• The greater the number of positive attachment life events the greater the health assessment (r=0.38, p=0.008)
• Having a stable foster placement is related to higher academic adjustment t(44)=-3.50, p=0.001), higher satisfaction with the placement t(48)=-3.20, p=0.002), health; t(47)=-4.94, p<0.001), and higher adjustment scores
Parenting Variables
• Caseworkers were asked to rate carers on a number of variables relating to parenting styles and skills
• ‘the ability in relation to managing the child’ and disciplinary style were the more problematic areas noted
• Those with a younger child were more likely to be rated as never having a problem with disciplinary style or level of aggression in parenting (81%) than were those with an older child (38%)
Caseworkers’ Assessments of Parenting Styles
Rating
Responsiveness
%
Ability to
express
warmth
%
Ability to
respond
sensitively
%
Ability in
relation to
managing
child
%
Disciplinary
style/ level of
aggression
%
Never a problem 66 77 80 47 59
Problem
developed or
resolved
34 23 20 53 42
Total 100 100 100 100 100
Parenting VariablesResponsiveness • Problems with the carer’s responsiveness was negatively related to the
child’s academic adjustment (=-0.49, p=0.001)• The caseworker’s overall satisfaction with the placement (=-0.47, p=0.001)• The child’s overall adjustment (=-0.65, p<0.001)• And health (=-0.48, p=0.001)Warmth• Problems with the carer’s ability to express warmth towards the child was
negatively related to the caseworker’s overall satisfaction with the placement (=-0.50, p<0.001)
• the child’s overall adjustment (=-0.55, p<0.001)• And health (=-0.40, p=0.005). There was no association with the child’s
ease of making friends or academic progress Sensitivity• Problems with the carer’s ability to respond sensitively was negatively
related to the child’s academic adjustment (=-0.33, p=0.023)• The caseworker’s overall satisfaction with the placement (=-0.59, p<0.001),
the overall adjustment (=-0.64, p<0.001)• The child’s health (=-0.44, p=0.002).
Ability to manage child• The carer’s ability in relation to managing the child was negatively related
to the caseworker’s overall satisfaction with the placement (=-0.30, p=032)
• The child’s overall adjustment (=-0.39, p=0.006)• And health (=-0.35, p=0.014). Disciplinary Style / Level of Aggression• The carer’s disciplinary style or level of aggression in parenting was
negatively related to the child’s academic adjustment (=-0.35, p=0.015)• The caseworker’s overall satisfaction with the placement (=-0.45,
p=0.001)• Overall adjustment (=-0.62, p<0.001)• And health (=-0.59, p<0.001) Stressors on Carers• Rating of the child’s overall adjustment is higher on average in the
absence of a stressor on carers that is related to the care of the child (t(47)=-2.26, p=0.029).
Parenting Variables (cont)
Conclusion Psychological need• Findings from this research and previous studies (Farmer et al, 2004; McCarthy et al,
2003) underline the importance of recognising emotional and behavioural difficulties experienced by children in care early and identifying their impact on carers.
• Vulnerabilities and strengths of children based on gender and age, and the need for individualised and differential responses from carers and caseworkers.
Self concept and self esteem• The children’s self esteem levels were lower than published normative data,
reaffirming the children’s level of need. • This result points to the need to assess more specific aspects of self esteem to better
understand the needs of children in care.• Consistent with a resilience orientation interventions may include fostering children’s
relationship building skills and reinforcing their pro-social behaviours and self worth, or finding turning points in their schooling through mentoring and extracurricular opportunities and positive peer and adult attachment relationships.
Family and social relationships• While acknowledging strong attachments with their foster parents children desired
more contact with their family of origin. • Contact remains a challenging and contentious issue (Cleaver, 2000) and carers
must be supported in their dual task of building strong attachments with their foster children while responding to the children’s need for continuing connection with birth families
Conclusion (cont)
• Children reported good levels of cohesion with foster carers at 3 interviews. Significant relationships emerged regarding the children’s judgment of their interpersonal skills and attachment with their foster parents
• Resources and training to enable carers and care systems to build on these strengths is stressed
• The nature of the relationship with the foster fathers appear to have had an important developmental influence on the children. Developing approaches to promote fuller involvement of fathers in fostering relationships are important to outcomes for children
• Encouraging child consumers’ right to self expression (Gilligan, 2002) and honouring children’s voices and knowledge in the development of child-centred policy and practice is stressed