Paper
Patterns of services for maltreated children: an eight year follow-up of english children suffering significant harm
- issue: Issue 1 / 2009
- authors: Marian Brandon, June Thoburn
- keywords: children, maltreatment, longitudinal study, United Kingdom
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abstract
Background. This paper presents findings from a prospective longitudinal study which set out to track the progress of 105 children and young people newly identified as having suffered, or being likely to suffer, significant harm through maltreatment (including neglect) in 4 English local authorities. Numerous and enduring risks to healthy development have been linked to child maltreatment.
However, Cicchetti and Toth (1997) and Rutter (2000) claim that while there is a documented risk of poor developmental outcomes, some maltreated children come through with developmental competence. This longitudinal study examines children's experiences and patterns of services as a contribution to this cross national debate.
Research questions. To track the progress and well being of 105 children from the point of identification of significant harm; to discover whether the children suffered further episodes of maltreatment; to discover the ways in which they were, or were not protected from significant harm, or significant impairment of their development; to discern whether any combinations of social work and other services (including out of home care) were associated with more or less successful outcomes.
Methods. Mixed methods were used and baseline information was collected on all 105 children at the point of identification of significant harm.
Child outcome data were analysed 12-18 months later (Phase 1); 77 of the 105 children were followed up using similar measures 8-9 years later (Phase 2). We triangulated and analysed a composite of information from structured file searches, interviews (with children and parents/carers) and standardised scales during both phases.
Findings. Findings in relation to the follow up with 77 children:
- 57% of the children experienced further maltreatment. A number of variables were statistically significantly associated with re-abuse. Children who suffered further episodes of abuse or neglect were significantly more likely to have experienced disrupted care; more likely to have conduct problems at home and school; and more likely to receive intensive social services intervention throughout the period of the study.
- 22% of the children experienced the death of a parent over the 8 years of the study. All of these children had experienced the additional loss of multiple moves.
- Over half of the children had lived with domestic violence. Interviews with the children revealed the different and changing circumstances of this family violence (including within foster care) which was usually hidden and which they could rarely discuss or get help with.
- Some children, appeared to have made very good progress in spite of repeated moves, losses, disruption and re-abuse.
Patterns of Services for the 77 children. Just over a third of the children's cases (26) had been closed early to social services and stayed closed. In eight of these 'closed' cases further problems resurfaced but did not reach the threshold for social services intervention, and it is unclear whether any help was provided. Almost two thirds of the 77 children received long term social services intervention over many years, defying the 'quick fix' philosophy of much service planning. A substantial number of these cases (29) were still 'open' seven or eight years after significant harm was first identified.
Outcome and Services. For around a quarter of the children the long-term outcome was rated as likely to be 'poor' and for three quarters (including the closed cases ) it was rated as 'moderate' or 'good' with the children being ' safe' at least. A group of nine of these children stood out as having a very good outcome. Each had been helped to cope with extreme adversity and the serious problems which surrounded, or stemmed from the circumstances which brought them into the child protection arena. All nine children had eventually experienced long periods of security and stability and developed good relationships. All but one of these children however had left their parental home and not returned. They were living with relatives, or were permanently placed, away from birth families (four with relatives, three in foster care, while one had been adopted as a baby).
Conclusions. This longitudinal study has demonstrated that there are no 'quick fixes' when children are abused or seriously neglected. Even where cases are closed early to social services, children may struggle to achieve reasonable levels of overall development. Some of the children in long term out of home care did very well, which is an important reminder that the negative impact of care should not be overstated. We cannot, from our data, attribute either success or negative outcomes to competent or incompetent practice. But we can learn from the successful cases and work to support parents and carers to help children to manage their losses and to make good relationships.
Working with maltreated children requires fine judgements requiring highly skilled professionals to work together, and with parents, carers and children, to achieve the positive changes that we saw for some of the children.
Key references
Brandon, M., Thoburn, J., Lewis, A., & Way, A., (1999). Safeguarding Children with the Children Act 1989. London: The Stationery Office.
Brandon, M., Thoburn, J., Rose, S., & Belderson, P., (2005). Living with Significant Harm: a follow up study. NSPCC, Inform.
Cicchetti, D. & Toth, S. L. (1997). Transactional ecological systems in developmental pathology. In S. Luthar, J. Burack, D. Cicchetti, & J. Weisz (Eds.), Developmental Psychopathology: Perspectives on Adjustment, Risk and Disorder. Cambridge: Cambridge University Press.
Rutter, M., (2000). Resilience Reconsidered: Conceptual Considerations, Empirical Findings, and Policy Implications. In S. J. Meisels & J.P. Shonkoff (Eds.), Handbook of Early Childhood Intervention (2nd ed.). Cambridge: Cambridge University Press.
Contacts: Marian Brandon, Senior Lecturer in Social Work, University of East Anglia, England, School of Social Work and Psychosocial Sciences, Elizabeth Fry Building, University of East Anglia, Norwich NR4 7TJ, E-mail: m.brandon@uea.ac.uk, Phone: 0044 (0)1603 592068.